The anterior approach in treatment of subaxial cervical spine injuries. (A group of 75 patients)
Vanĕk, P.; Sames, M.
Rozhledy V Chirurgii Mesicnik Ceskoslovenske Chirurgicke Spolecnosti 83(3): 107-112
2004
ISSN/ISBN: 0035-9351 PMID: 15216692 Document Number: 568802
The aim of the study was to evaluate long-term results of the subaxial cervical spine injuries treatment, using splint and bicortical screws stabilization via frontal access, as well as to describe the opinion on subaxial cervical spine injuries treatment methods development. During a twelve-year period, starting in 1990, 75 patients suffering from subaxial cervical spine injuries were treated by the authors' work-team. In 96% of the cases, decompression followed by frontal access stabilization using the Caspar technique with a splint and bicortically inserted screws was performed. The Ducker and Cooper classification scale was employed to classify the fracture type. A neurological deficit was classified according to Frankel. The trauma mechanism was determined, as well as peri- and post operation complications and the patients survival rate. Furthermore, the graphic documentation taken during the observation period was assessed. In the patient group, the number of male subjects was three times higher and 56% of the patients under the age of 30 were reported. 40% of the patients were injured in conjunction with a traffic accident, 27% were injured following a fall from a height and 15% after jumping into unknown water. 30% of the patient fractures were classified as flexion-compression types, 30% as flexion-dislocation types, 32% as burst-compression types and 6% as extension fracture types. 22% of the patients were accepted as Frankel A, 7% as B, 5% as C, 14% as D and 52% were Frankel E. 91% of the patients suffered from monotrauma. 96% of the patients, using the frontal access exclusively, were treated with splints, bicortical screws and autologic grafts. The neurological picture improved in 8% of the patients, 15% died in the first year. The surgical treatment should be aimed at the earliest possible decompression of the neurological tissue, followed by re-introduction of the stable situation. The frontal access may be, in the majority of cases, considered the access of choice.