Three Kinds Of Surgical Approach For The Treatment Of Lower Cervical Spine Fracture And Dislocation And Compared The Efficacy Of Spinal Cord Injury

Objectives: Through the analysis of clinical cases of cervical spinal cord injury due tothe lower cervical spine fracture and dislocation, explore the surgical treatment of the threesurgical approach in the treatment of lower cervical fracture and dislocation with spinalcord injury efficacy and surgical time window recovery of spinal cord function.Methods:Retrospective analysis methods subsidiary Provincial Hospital of ShandongUniversity of Traditional Chinese Medicine from May2009to September2012,36patients were treated under the cervical spine (C3~C7) fracture dislocation of spinal cordinjury patients complete medical records of32patientsfollow-up analysis and comparativestatistical study.20cases accept the surgical treatment in3days;12cases accept thesurgical treatment after3days. Blood loss and operative time to adopt spss17.0softwarefor data analysis, Postoperative neurologic recovery cervical JOA (Japanese OrthopaedicAssociation) score (see Table1) and Frankel spinal cord injury classification method (seeTable2) compared Evaluation of spinal cord nerve function to improve the situation bycalculating the recovery rate. Cases of patients admitted to hospital after a clear diagnosisof cervical spine fracture dislocation and spinal cord injury, appropriate and agreed to betreated surgically after admission are accepted conventional cervical x-ray, spiral CT(three-dimensional reconstruction) and MRI, Limb sensory examination showedsignificant spinal cord injury and dysfunction. The fracture dislocation segments:12casesof the C4-5vertebral,14cases of the C5-6vertebral,6cases of the C6-7vertebral. Allpatients were observed after bone fusion unified cervical X-ray, CT is unclear, because ofartifacts(Foreign body artifacts)..Result: The operation is successful, no perioperative deaths, intraoperative bleeding and spinal cord accident injury does not appear. All patients were followed, Up for6to18months, An average of12.7months. The anterior group1patients after2weeksperspective see the titanium mesh slightly offset, with no obvious discomfort, anappropriate extension of the neck collar external fixation time four months after the reviewand fusion, no significant change within the fixed position.The rest of the surgery inpatients with no occurrence of serious complications such as loosening. Anterior operativetime was significantly less than posterior group and the combination group, a significantdifference (P <0.05); blood loss less than posterior group and the combination group, thereis a significant difference (P <0.05); surgery recovery of neurological function after spinalcord, there was some improvement in the three groups of patients with postoperative JOAscores compared with preoperative (P <0.01), and significant differences were statisticallysignificant. No significant difference in the rate of improvement between the three surgicalapproach group (all P>0.05).6months after spinal cord function Frankel grade, in additionto the six cases of complete spinal cord injury, Spinal cord function has no significantrecovery.26cases of incomplete spinal cord injury patients has different levels ofpostoperative recovery in6to12months. Preoperative classification of spinal cord injuryhas a significantly affect to the postoperative recovery, and has significant (rank sum test, P<0.05).Conclusions: The lower cervical spine fracture dislocation with spinal cord injurypatients, surgical treatment can significantly promote functional recovery of the spinal cord.Three surgical treatment were similar surgery earlier the treatment, the more favorable thefunctional recovery of the injured spinal cord. Anterior surgery is superior to the thePosterior group and combined anterior group in terms of operation time and the amount ofbleeding.