Subaxial cervical spine injuries: Outcomes after anterior corpectomy and instrumentation

Abstract

Study Design: This is prospective study. Purpose: The purpose of this study is to assess the functional, neurological, and radiological outcomes of the patients of subaxial cervical spine injuries treated by anterior corpectomy and stabilization with anterior cervical locking plate and cage filled with bone. Overview of the Literature: The principles in the treatment of unstable cervical spine injuries are reduction and stabilization of the injured segment, maintenance of cervical lordosis and decompression where indicated and ranges from nonoperative to combined anterior and posterior surgical fusion. There is, however, debate on the indications for anterior, posterior, or combined surgery. Materials and Methods: The present study of 99 patients includes prospective patients of subaxial cervical spine injuries between February 2014 and February 2016 admitted and operated to Indira Gandhi Medical College, Shimla. Bony fusion, neurological recovery, Neck Disability Index and complication were studied in all patients. The mean follow-up period was 27 months (range 12–42 months). Results: Of the 99 procedures, 77 (77.8%) involved a single vertebral level, 19 (19.2%) involved two levels, and 3 (3%) involved three levels corpectomy. The mean Neck Disability Index was 7.57 ± 5.42. Definitive Bridwell Grade 1 fusion was seen in 64.6% of the cases. No deterioration of neurological symptoms was seen. Dysphagia was the most common complication in 79 (79.8%) patients. One patient had minimal screw back out. Conclusions: Anterior cervical corpectomy and stabilization with cage filled with bone and cervical reflex locking plate are good method for subaxial cervical spine injuries with good fusion rates and probably procedure of choice for posttraumatic multiple disc prolapse with reduced hazards of multiple grafts.

Comparison of the Operative Time and Post-Operative Pain with Peek Cage versus Autologous Iliac Crest Bone Graft in Anterior Cervical Discectomy and Fusion

“…4,[13][14][15] ACDF has also been used in trauma patients where intervertebral disc is disrupted along with fracture or subluxation. 17,18 Conventionally, autologous bone graft has been used for fusion between end plates of vertebral bodies and is secured with a buttress of anterior plate. Most commonly, the graft is harvested from iliac crest.…”

Biomechanical effects of different approaches and titanium mesh in combined anterior cervical corpectomy decompression and fusion：a finite element study

“…In clinical practice, after partial vertebrectomy, titanium mesh is commonly used to support and fuse the vertebral body [13][14][15][16][17][18][19]. Research by the Lu team suggests that titanium mesh cages (TMC) can provide su cient biomechanical stability and have high clinical e cacy.…”

Safety of anterior cervical corpectomy and fusion (ACCF) for the treatment of subaxial cervical spine injuries, a single center comparative matched analysis

“…Depending on the various mechanisms and extent of injury, a range of surgical methods and approaches may be used. Anterior Cervical Discectomy and Fusion (ACDF) and Anterior Cervical Corpectomy and Fusion (ACCF) are both viable surgical approaches in the management of pathologies of the cervical spine [ 3 , 11 , 17 , 19 , 26 , 28 ]. Although both largely established in spine surgery [ 23 , 25 ], there are no clear guidelines surrounding the use of one or the other of the techniques in the setting of subaxial traumatic injuries.…”