Stabilization for Sub Axial Cervical Spine Injury

Abstract

A retrospective analysis of sixty patients with cervical spinal cord injury operated during Jan 2001 to Dec 2003 was carried out. Fifty four (90%) were male and six were female patients. Amongst them 45 (75%) were in the age group 21 to 40 years. Thirty six (60%) sustained injury by vehicular accident and 24 due to fall, wrestling, boxing, obstacle crossing, terrorist activities, cattle and camel hits. All patients presented with evidence of post-traumatic cervical spinal cord injury and evaluated with Frankel's neurological grade at admission. Six patients presented with grade ‘A’, 02 grade ‘B’, 36 grade ‘C’, 16 grade ‘D’ neurological deficit as per Frankel's classification. Plain radiography, Computerised tomography (CT) Scan and Magnetic Resonance Imaging (MRI) of cervical spine revealed disc prolapse in 30, anterior thecal compression due to burst/compression fracture in 24 and dislocation in 06 patients. Cord contusion and haematoma in 08 and cord transection in 04 patients were detected in MRI. Anterior Cervical Microdiscectomy (ACD) and fusion in 10; discectomy, fusion and titanium plating in 20; corpectomy and bone grafting in 05; corpectomy and cage placement in 03; corpectomy, bone grafting and titanium plating in 16, post fusion was carried out in 06 cases. Postoperative radiography showed good alignment, stability of spine and implants in position. Outcome was evaluated again with Frankel's scale. There were 26 patients with grade ‘E’, 25 grade ‘D’, 01 grade ‘C’, 06 patients did not show any recovery and 02 patients died. Recovery was rewarding in patients with initial incomplete spinal cord injury.

Keywords

cervical spine injury - functional recovery - stabilization

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