Anterior reduction and decompression for the treatment of lower cervical spine dislocation by zero profile anterior cervical interbody fusion system

English Keywords:Cervical vertebra  Facet joint dislocation  Zero profile anterior cervical interbody fusion system

English Abstract:

  【Abstract】 Objectives: To investigate the effect of anterior cervical decompression, reduction and internal fixation with zero profile interbody fusion system for the treatment of lower cervical spine dislocation. Methods: 25 cases suffering from dislocation of the lower cervical spine and without merge laminar fracture were reviewed retrospectively, the Frankel grade included: grade A in 4 cases, grade B in 10 cases, grade C in 6 cases, grade D in 4 cases, and grade E in 1 case. Injury site included: C3/4 in 2 cases, C4/5 in 5 cases, C5/6 in 8 cases, C6/7 in 10 cases. The duration from injury to the admission was 2h-3d, with an average of 7.6h. Unilateral facet lockage was noted in 8 cases, and bilateral lockage in 17 cases. 25 cases experienced anterior cervical decompression, reduction and internal fixation with zero profile interbody fusion system. Results: Under general anesthesia, the skull traction weight was 10-15kg in 10-30min, 13 cases reached reduction, while 12 cases had no effect. 8 cases with unilateral facet lockage reached reduction through discectomy and decompression; 4 patients with bilateral facet joint lockage got reduction through discectomy and distraction. The operation time was 40-82min(average 61±12min), the bleeding volume was 100-600ml(average 180±25ml). The patients were followed up for 5-12 months(average 6.8±2.2 months). 1 case was complicated with cerebrospinal fluid leakage, no complication such as major blood vessel, recurrent laryngeal nerve injury or pneumothorax was noted. No case suffered from postoperative swallowing discomfort. 3-5 months later, intervertebral bony fusion was noted, and 25 cases reached good cervical spine alignment, no internal fixation or fracture was noted. All cases except for 2 grade A, 3 grade B, 1 grade C, 1 grade D and 1 grade E had good improvement of neurofunction at final follow-up, while the rest had different degrees of improvement. Preoperative JOA score of 7.2±0.8 points improved to 13.8±0.6 of final follow-up, with the improvement rate as 67.3%. Conclusions: One stage anterior cervical reduction and decompression with zero profile anterior cervical interbody fusion system is reliable for cervical dislocation, which is of early reduction and well neurological recovery as well as less incidence of complications.