| Objective: To discuss the value of Daxamethasone and Mannitol applied to anterior approach decompression, bone grafting and plate fixation for inferior cervical spine fracture and dislocation accompany cervical spinal cord. The inferior cervical spine fracture and dislocation accompany cervical spinal cord is a grave trauma. The patients with inferior cervical fracture and dislocation accompanied with cervical spinal cord injury always have neck pain, limited function of cervical spine, Sensation and movement and sphincter function serious nerve functional impairment. Treatments of the disease includes reconstruction of cervical vertebral sequences, maintain stability of cervical spine. restoration, restore the cervical spinal physiological curvature and intervertebral height, release the spinal cord complication. All of the treatments were used to enlarge the volume of vertebral canal, protect the the spinal cord from the further impair, Create opportunity for neurous function recovery, aviod various complication. the druge of non- surgical operation include Daxamethasone and mannitol. Decompression and Reduction is a effective methods in operation precedures. Daxamethasone and mannitol were rarely used in peri- operative. Daxamethasone and mannitol was used in operative procedure is not reported in literature. ischemia reperfusion injury is a very common Pathology phonomenon in clinical. With the deepening study of ischemia reperfusion injury, it does more important role in the spinal cord injury and supports for Daxamethasone and mannitol used in spinal cord injury patients. To analysis the effect of Daxamethasone and mannitol in treatment of lower cervical fracture and dislocation acompanied with cervical spinal cord injury. Dexamethasone and mannitol was used during of Anterior approach cervical discectomy and internal fixation in the treatment of inferior cervical fracture and dislocation acompanied with cervical spinal cord injury.Methods: A total of 39 patients with wer cervical fracture and dislocation acompanied with cervical spinal cord injury were studied retrospective from Jan. 2009 to Aug.2010 in the department of spine surgery, the third hospital of HeBei medical university. all patients, clinical sympotom and image results was recorded.the preoperation/postoperation neurous function was evaluated according to Frankel neurous functional classification. JOA scoring system was used to determine pre-and postoperative functional status. the concentration of hormone and 20% mannitol, duration of disease was recorded. pre- and postoperative cervical curvature, the height of vertebrae and internertebral disc, the horizontal distance of Sagittal vertebral body was recorded in CT. the volumn of cervical canal and MRI T2WI spinal cord signal intensity was observed in cervical MRI. Statistical analysis was performed with SPSS 13.0.Results:1 In the test group, The comparison of Frankel value before surgery and 7 days after surgery: 3 patients is same, 7 patients have evaluated 1grades, 4 patients have evaluated 2 grades, 3 patients have evaluated 3 grades. The comparison of Frankel value before surgery and 6 months after surgery: 1 patients is same, 3 patients have evaluated 1grades, 9 patients have evaluated2 grades, 4 patients have evaluated 3 grades. 2 In the control group, The comparison of Frankel value before surgery and 7 days after surgery: 6 patients is same, 11patients have evaluated 1grades, 4 patients have evaluated 2 grades, 1 patients have evaluated 3 grades. The comparison of Frankel value before surgery and 6 months after surgery: 3 patients is same, 10 patients have evaluated 1grades, 7 patients have evaluated 2 grades, 2 patients have evaluated 3 grades.3 In the test group, The JOA score before surgery of 17 patients who were treated with mannitol and dexamethasone is 4.7±1.0,and at 7 days after operation is 9.8±2.3,and at 6months after operation is 12.6±3.5 . There is a significant statistical difference between before and after operation(P<0.01).4 In the control group, the JOA score before surgery of 22 patients who were not treated with mannitol and dexamethasone is 4.9±1.2, and at 7 days after operation is 8.4±1.7, and at 6months after operation is10.4±2.6. There is a statistical difference between before and after operation (P<0.01).5 The comparison of the JOA score before surgery of patients In the test group and In the control group: 4.7±1.0and4.9±1.2. There is no significant statistical difference between the two groups(P>0.05). and at 7 days after operation are 9.8±2.3and 8.4±1.7. There is a statistical difference between patients of the test group and the control group(P<0.05). at 6months after operation are12.6±3.5and10.4±2.6. There is a statistical difference between patients of the test group and the control group(P<0.05).Conclusion: The use of dexamethasone and mannitol during of of Anterior approach cervical discectomy and internal fixation in the treatment of inferior cervical fracture and dislocation acompanied with cervical spinal cord injury can protect the spinal from the secondary damage, improve the recovery ratio of spinal cord.
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