Surgical Treatment For Fracture And Dislocation Of Lower Cervical Spine Of The Clinical Study

[Objective] To investigate the surgical treatment methods and operative outcomes of the lower cervical spine fracture and dislocation[Methods] Retrospective analysis of September 2005 to October 2010 the 61 cases of the lower cervical spine fracture and dislocation patients in our hospital with different surgical treatment of the medical records . All cases were classified into three groups , Closed reduction of anterior group , A posterior open reduction group , A combined anterior and posterior reduction group. 34 cases anterior approach, 25 cases posterior approach, 2 cases combined anterior and posterior approach. Terms of clinical effects applying Frankel functional classification standard spinal cord injury and JOA improved standards, comprehensive evalation Frankel functional classification of spinal cord injury and sensory, motor score changes of the cervical spinal cord injury before and after surgery. Observe the intraoperative and postoperative complications, Observe postoperative neurologic recovery and the vertebral body reattachment.[Results] Postoperative follow-up time was 6-31 months, an average of 19 months, all patients were clinic or telephone follow-up . All patients has no anterior Esophagus and Trachea fistula occurred, no major vascular bleeding, one patient appears slight difficulty in breathing and a small number of sputum, inhalation and given oxygen inhalation in patients with symptomatic treatment, symptoms disappeared after three days .Reviewe cervical spine X-ray, anterior bone graft all with in 5 months after surgery obtain bone fusion, all patients after surgery were satisfied with the reset, bone graft and fusion phenomenon did not occur, cervical structure sequence did not change, postoperative cervical lordosis presence, the hight of intervertebral is normal, limb symptoms disappear or basic relief, neck pain disappeared after within a month after the operation, no loosening or breakage of internal fixation, Frankel functional classification of spinal cord injury improved in varying degrees, score increase 1-2 grade, only two patients with a preoperative score with Frankel grade A-level no significant inprovement, Grading according to JOA, preoperative and postoperative follow-up scores were statistically significant differences.[Conclusions] Patients with lower cervical spine fracture and dislocation should as soon as possible to large-weight skull traction under the surveillance of the C-arm after admission, when reset fails we should as soon as possible to have a operation, according to the specific injured to choose anterior, posterior or combined anterior and posterior surgical reduction for the treatment. anterior, posterior or combined anterior and posterior surgical all can achieve reconstruction of the cervical sequence and stability, replacement, decompression and to restore the effect of spinal cord function, and everyone has the advantages and disadvantages. We should select the appropriate surcal approach on the basis of injury mechanism, style and in different parts of injury.