Anterior Reduction for Cervical Spine Dislocation

Reindl, Rudy; Ouellet, Jean; Harvey, Edward J.; Berry, Greg; Arlet, Vincent

doi:10.1097/01.brs.0000202811.03476.a0

Cited by 116 publications

(99 citation statements)

References 25 publications

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“…In regard to the trauma literature, conclusions that might be drawn from several previous studies suffer on heterogeneous samples [3,7,33,40,44,55,57,59,62,67,77,82,83,89,95], and direct comparisons of results after different treatments remain difficult [29,81]. But the accurate collection of qualitative outcome data is essential because it reflects what is relevant to the patient and society [33].…”

Section: Discussionmentioning

confidence: 99%

“…Prior to surgery, four out of eight patients with unilateral dislocated facets were subjected to successful manual reduction and four patients had axial traction for gross realignment and open reduction [77] was performed at time of anterior surgery. One patient underwent corpectomy of C5, whereas the others had discectomy, intervertebral strut grafting and plating.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…In the treatment of subaxial cervical injuries several authors reported that the restoration of cervical lordosis using ACDFP was not a major problem and that the reconstruction did not encounter a significant loss in the long-term [3,56,77]. However, the incidence of radiographic failure and loss of alignment relates to its definition.…”

Section: Reconstruction and Maintenance Of Sagittal Alignmentmentioning

confidence: 99%

“…However, the incidence of radiographic failure and loss of alignment relates to its definition. The series of Aebi [3] and Reindl [77] defined construct failure as [10°kyphosis. Johnson [54] used a change in translation of [3.5 mm and angulation [11°w hich was present in 13% of patients as compared to 31% in the current series using [5°as cut-off.…”

Section: Reconstruction and Maintenance Of Sagittal Alignmentmentioning

confidence: 99%

“…The anterior approach is a non-traumatic and it provides the ability for decompression, reduction of dislocated facet joints, interbody grafting with reconstruction and maintenance of lordosis [3,21,33,48,58,77]. ACDFP also reduces the need to sacrifice adjacent motion segments in cases of facet joint injury which precludes single-level posterior fixation [81].…”

Section: Introductionmentioning

confidence: 99%

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Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries

et al. 2009

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The management of patients with subaxial cervical injuries lacks consensus, particularly in regard to the decision which surgical approach or combination of approaches to use and which approach yields the best clinical outcome in the distinct injury. The trauma literature is replete with reports of surgical techniques, complications and gross outcome assessment in heterogeneous samples. However, data on functional and clinical outcome using validated outcome measures are scanty. Therefore, the authors performed a study on plated anterior cervical decompression and fusion for unstable subaxial injuries with focus on clinical outcome. For the purpose of a strongly homogenous subgroup of patients with subaxial injuries without spinal cord injuries, robust criteria were applied that were fulfilled by 28 patients out of an original series of 131 subaxial injuries. Twenty-six patients subjected to 1-and 2-level fusions without having spinal cord injury could be surveyed after a mean of 5.5 years (range 16-128 months). The cervical spine injury severity score averaged 9.6. Cross-sectional outcome assessment included validated outcome measures (Neck pain disability index, Cervical Spine Outcome Questionnaire, SF-36), the investigation of construct failure and successful surgical outcome were defined by strict criteria, the reconstruction and maintenance of local and total cervical lordosis, adjacent-segment degeneration and intervertebral motion, and the fusion-rate using an interobserver assessment. Selfrated clinical outcome was excellent or good in 81% of patients and moderate or poor in 19% that corresponded to the results of the validated outcome measures. Results of the NPDI averaged 12.4 ± 12.7% (0-40). With the SF-36 mean physical and mental component summary scores were 47.0 ± 9.8 (18.2-59.3) and 52.2 ± 12.4 (14.6-75.3), respectively. Using merely non-constrained plates, construct failure was observed in 31% of cases and loss of local lordosis, expressed as a mean injury angle of 14°, postoperative angle of -5.5°and follow-up angle of -1°, was significant. However, total cervical lordosis was within the limits of normalcy (-24.3°± 13.3) and fusion-rate was 88.5%. The progression of adjacent-level degeneration was shown to be significantly influenced by a decreased plate-to-disc-distance. Adjacent-level intervertebral motion was not altered due to the adjacent fusion, but reduced in Electronic supplementary material The online version of this article

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