The Comparison Of Three Surgical Strategies In Treating Subaxial Cervical Facet Dislocation With No Or Mild, Moderate Spinal Cord Injury

Objective:To compare anterior decompression of spinal cord, traction, reduction intervertebral bone graft fusion and fixation surgery monitored by spinal cord evoked potential; anterior decompression of spinal cord, posterior reduction and anterior fixation surgery; posterior reduction, anterior decompression of spinal bone graft fusion and fixation surgery and discuss the advantages and disadvantages of the three kinds of strategy in the treatment of no or mild, moderate spinal cord injury (Frankel grade C, D, E) of the patients with cervical facet dislocation, to provide the best treatment strategy for cervical facet dislocation with no or mild, moderate spinal cord injury patientsMethods:Retrospective study to yantai shan hospital to treat55subaxial cervical facet dislocation cases with no or mild, moderate spinal cord injury (Frankel grade C, D, E), from July2005to December2013. According to the surgical strategy the patients is divided into three groups. Group A:anterior decompression of spinal cord, traction, reduction intervertebral bone graft fusion and fixation surgery monitored by spinal cord evoked potential; Group B:anterior decompression of spinal cord, posterior reduction and anterior fixation surgery; Group C:accept posterior reduction, anterior decompression of spinal bone graft fusion and fixation surgery. To compare the time to surgery, longevity of surgery, blood loss, the rate of spinal cord injury, the recovery rate of spinal function.Results:The time to surgery:3.8±1.1days of group A, group B3.6±0.7days, group C3.6±0.8 days; longevity of surgery:group A185.9±29.4min, group B169.7±12.6min, group C152.5±12.2min. After operation Frankel grade reduce:group A:0%(0/17), group B:20%(4/20), group C:11.1%(2/18), Frankel grade improve:group A:29.4%(5/17), group B:15%(3/20), group C:15.6%(3/18). Blood loss:group A155.3±60.2ml, group B258.9±58.7ml,group C±21.0229.4ml. I The time to surgery between the three groups was not significant (0.5<P<0.75), the longevity of surgery:group C<group B<A group (P<0.01); Interoperate blood loss:group A<group C<group B (P <0.01); After operation Frankel grade reduce:group A<group C<group B (P<0.01), Frankel grade improve:group B<group A (P<0.01), group C<group A (P<0.01), group B and C group was not significant (0.25<P<0.5).Conclusion:We recommend ACDF by SCEP to the spinal cord injury (Frankel grade D, E) patients with subaxial cervical facet dislocation.