EFFECTIVENESS AND SAFETY OF SIMPLY ANTERIOR APPROACH FOR LOWER CERVICAL SPINE FRACTURE DISLOCATION (Allen-Ferguson II OR III TYPE) WITHOUT SPINAL CORD INJURY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 ZHUYanming , YUEErsong , KONGQuanwei

Department of Orthopedics, Henan Meitan General Hospital, Zhengzhou Henan, 450003, P.R.China;

Corresponding author：

ZHUYanming, Email: zyanming2010@126.com

Keywords：

Cervical spine; Fracture and dislocation; Locked-facet; Spinal cord injury; Anterior approach

DOI：

10.7507/1002-1892.20160290

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To study the effectiveness and safety of simply anterior approach for lower cervical spine fracture dislocation (Allen-Ferguson II or III type) without spinal cord injury. Methods Twenty-five patients with lower cervical spine fracture dislocation (Allen-Ferguson II or III type) without spinal cord injury were treated between June 2013 and June 2015. There were 17 males and 8 females with an average age of 41.2 years (range, 31-57 years). Injury was caused by falling from height in 11 cases, by bruise in 5 cases, by crash of heavy object in 6 cases, and by traffic accident in 3 cases. There were 24 cases of fresh fractures and 1 case of old fracture. According to the Frankel grading criteria, 19 cases were rated as grade E and 6 cases as grade D. The injured levels included C_{4, 5} in 5 cases, C_{5, 6} in 14 cases, and C_{6, 7} in 6 cases. Unilateral locked-facet joint was observed in 9 cases, and bilateral locked-facet joint in 16 cases. The operation time, intraoperative blood loss, and surgical complications were recorded; the Odom standard was used to evaluate the effectiveness. The Cobb angle and D-value (the degree of cervical kyphosis or lordosis) were measured on the X-ray film, the bone graft fusion rate was recorded. Results The operation was successfully completed in 25 patients; the operation time was 66 to 115 minutes, the intraoperative blood loss was 80 to 220 mL. The postoperative follow-up time was 12 to 36 months (mean, 19.3 months). Postoperative temporary dysphagia occurred in 1 case, and pain at donor site in 2 cases; there were no complications of spinal cord injury, hematoma, hoarse, and esophageal fistula. The nerve function was improved from preoperative grade D to postoperative grade E at 3 months. The X-ray films showed bone graft fusion; there was no loss of intervertebral height or loosening of internal fixation. At 3 months after operation, the effectiveness was excellent in 18 cases, good in 6 cases, and fair in 1 case, and the excellent and good rate was 96.0%. The postoperative Cobb angle and the D value were significantly improved when compared with preoperative ones (P < 0.05). Conclusion Simple anterior approach has the advantages of good effectiveness, small trauma, and fast recovery for treating lower cervical spine fracture dislocation (Allen-Ferguson II or III type) without spinal cord injury.

Citation： ZHUYanming, YUEErsong, KONGQuanwei. EFFECTIVENESS AND SAFETY OF SIMPLY ANTERIOR APPROACH FOR LOWER CERVICAL SPINE FRACTURE DISLOCATION (Allen-Ferguson II OR III TYPE) WITHOUT SPINAL CORD INJURY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(11): 1408-1411. doi: 10.7507/1002-1892.20160290 Copy

1.	陈举, 张朝春.全麻下颅骨牵引复位配合颈前路减压融合治疗下颈椎骨折脱位伴关节突交锁.第三军医大学学报, 2016, 38(1): 93-96.
2.	Riesenburger RI, Potluri T, Kulkarni N, et al. Unilateral cervical facet dislocation: a biomechanical study of several constructs including unilateral lateral mass fixation supplemented by an interspinous cable. J Neurosurg Spine, 2012, 16(3): 251-256.
3.	李玉伟, 严晓云, 王海蛟, 等.颈前路先减压后复位治疗下颈椎脱位临床观察.中华医学杂志, 2015, 95(41): 3384-3386.
4.	刘勇, 张国华, 兰天亮, 等.治疗下颈椎骨折脱位伴脊髓损伤的三种手术方式.中国矫形外科杂志, 2015, 23(16): 1461-1464.
5.	李玉伟, 王海蛟, 周小小, 等.前路复位减压零切迹椎间融合器内固定治疗下颈椎脱位.中国脊柱脊髓杂志, 2015, 25(7): 630-636.
6.	常巍, 王达义, 李兵奎, 等.一期后前路联合手术治疗下颈椎骨折脱位伴关节突绞锁.实用医学杂志, 2015, 31(12): 2069-2070.
7.	Liu P, Yang JS, Liu TJ, et al. Complete fracture-dislocation of the lower cervical spine without permanent neurological sequel: the typical imaging changes. Spine J, 2016, 16(3): e197-199.
8.	王建元, 邓强, 盛伟斌, 等.下颈椎骨折脱位修复方法的选择:植骨融合及颈椎稳定性分析.中国组织工程研究, 2015, 19(4): 522-530.
9.	骆渊城, 敖传西, 华贤章, 等.不同手术路径对下颈椎骨折脱位并脊髓损患者生理功能恢复的影响.中国医药导报, 2016, 13(21): 111-114.
10.	温松江.前后路联合手术治疗颈椎骨折脱位并脊髓损伤的临床效果观察.临床合理用药, 2016, 9(6A): 149-150.
11.	O'Shaughnessy J, Grenier JM, Stern PJ. A delayed diagnosis of bilateral facet dislocation of the cervicalspine: a case report. J Can Chiropr Assoc, 2014, 58(1): 45-51.
12.	Waschke A, Walter J, Duenisch P, et al. Anterior cervical intercorporal fusion in patients with osteoporotic or tumorous fractures using a cement augmented cervical plate system: first results of a prospective single-center study. J Spinal Disord Tech, 2013, 26(3): E112-117.
13.	张宏其.颈椎骨折与脱位治疗的几点思考.中华创伤杂志, 2014, 30(8): 759-761.
14.	刘纪恩, 曹珺, 勾瑞恩, 等. I期前后路联合手术治疗下颈椎骨折脱位合并颈髓损伤的疗效.中华创伤杂志, 2015, 31(12): 1077-1079.
15.	郭琰, 周方, 田耘, 等.下颈椎骨折脱位术式选择及疗效分析.中华创伤杂志, 2015, 31(3): 232-235.
16.	张广泉, 李琳, 高延征, 等.下颈椎骨折脱位伴关节突绞锁的治疗策略.中华创伤骨科杂志, 2013, 15(9): 810-812.
17.	Ngo LM, Aizawa T, Hoshikawa T, et al. Fracture and contralateral dislocation of the twin facet joints of the lower cervical spine. Eur Spine J, 2012, 21(2): 282-288.

1. 陈举, 张朝春.全麻下颅骨牵引复位配合颈前路减压融合治疗下颈椎骨折脱位伴关节突交锁.第三军医大学学报, 2016, 38(1): 93-96.
2. Riesenburger RI, Potluri T, Kulkarni N, et al. Unilateral cervical facet dislocation: a biomechanical study of several constructs including unilateral lateral mass fixation supplemented by an interspinous cable. J Neurosurg Spine, 2012, 16(3): 251-256.
3. 李玉伟, 严晓云, 王海蛟, 等.颈前路先减压后复位治疗下颈椎脱位临床观察.中华医学杂志, 2015, 95(41): 3384-3386.
4. 刘勇, 张国华, 兰天亮, 等.治疗下颈椎骨折脱位伴脊髓损伤的三种手术方式.中国矫形外科杂志, 2015, 23(16): 1461-1464.
5. 李玉伟, 王海蛟, 周小小, 等.前路复位减压零切迹椎间融合器内固定治疗下颈椎脱位.中国脊柱脊髓杂志, 2015, 25(7): 630-636.
6. 常巍, 王达义, 李兵奎, 等.一期后前路联合手术治疗下颈椎骨折脱位伴关节突绞锁.实用医学杂志, 2015, 31(12): 2069-2070.
7. Liu P, Yang JS, Liu TJ, et al. Complete fracture-dislocation of the lower cervical spine without permanent neurological sequel: the typical imaging changes. Spine J, 2016, 16(3): e197-199.
8. 王建元, 邓强, 盛伟斌, 等.下颈椎骨折脱位修复方法的选择:植骨融合及颈椎稳定性分析.中国组织工程研究, 2015, 19(4): 522-530.
9. 骆渊城, 敖传西, 华贤章, 等.不同手术路径对下颈椎骨折脱位并脊髓损患者生理功能恢复的影响.中国医药导报, 2016, 13(21): 111-114.
10. 温松江.前后路联合手术治疗颈椎骨折脱位并脊髓损伤的临床效果观察.临床合理用药, 2016, 9(6A): 149-150.
11. O'Shaughnessy J, Grenier JM, Stern PJ. A delayed diagnosis of bilateral facet dislocation of the cervicalspine: a case report. J Can Chiropr Assoc, 2014, 58(1): 45-51.
12. Waschke A, Walter J, Duenisch P, et al. Anterior cervical intercorporal fusion in patients with osteoporotic or tumorous fractures using a cement augmented cervical plate system: first results of a prospective single-center study. J Spinal Disord Tech, 2013, 26(3): E112-117.
13. 张宏其.颈椎骨折与脱位治疗的几点思考.中华创伤杂志, 2014, 30(8): 759-761.
14. 刘纪恩, 曹珺, 勾瑞恩, 等. I期前后路联合手术治疗下颈椎骨折脱位合并颈髓损伤的疗效.中华创伤杂志, 2015, 31(12): 1077-1079.
15. 郭琰, 周方, 田耘, 等.下颈椎骨折脱位术式选择及疗效分析.中华创伤杂志, 2015, 31(3): 232-235.
16. 张广泉, 李琳, 高延征, 等.下颈椎骨折脱位伴关节突绞锁的治疗策略.中华创伤骨科杂志, 2013, 15(9): 810-812.
17. Ngo LM, Aizawa T, Hoshikawa T, et al. Fracture and contralateral dislocation of the twin facet joints of the lower cervical spine. Eur Spine J, 2012, 21(2): 282-288.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS AND SAFETY OF SIMPLY ANTERIOR APPROACH FOR LOWER CERVICAL SPINE FRACTURE DISLOCATION (Allen-Ferguson II OR III TYPE) WITHOUT SPINAL CORD INJURY

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content