Anterior Approaches for Sub-Axial Cervical Fractures: Case Series

Authors

The Department of Neurosurgery, Faculty of Medicine, Aswan*, Assuit** and Ain Shams*** Universities

Abstract

Abstract Background: Sub-axial cervical spine fractures can have devastating sequalae. A third of all spine injuries occur in the cervical region. 70% of cervical trauma occurs in sub axial region. Failure of proper management to sub-axial cervical spine trauma can lead to permanent disability lack of consensus in the management of sub-axial fracture questions the efficiency of different surgical approaches. Aim of Study: Evaluation of different anterior surgical methods in treatment of sub-axial cervical spine trauma and fracture. Patients and Methods: 42 patients with sub-axial cervical spine fractures who all were treated surgically with anterior approach were recruited. Of 42, 21 (50%) had corpectomy and Pyramesh placement with plate and 21(50%) had ACDF with single/multiple cages with or without plating. We collected operative data and performed follow-up for 12 months post-operatively. The collected data were analyzed using the SPSS to detected significant differences between both groups. Study Design: Case series. Results: Age of patients in the Study groups ranged from 15 years to 70 years, (average 39.1±13.8 years). The injury levels in the majority of the 42 cases were at C4-5 (47.6%), C5-6 in (33.3%), C3-4 in (9.5%), C6-7 in (9.5%). Corpectomy group had significantly more blood loss and longer operative time than ACDF group. Both groups had similar rate of postoperative complications. Conclusion: Anterior approaches for sub-axial fractures are efficient in preserving neurological function and stabilizing the fractures. Moreover, anterior procedure takes short time and could be of significant value in patients with medical co-morbidities or when a short operative time is required.

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The Medical Journal of Cairo University
Volume 89, December
December 2021
Pages 2915-2922

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