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STAGE I COMPRESSIVE EXTENSION INJURY OF THE CERVICAL SPINE. IS IT A STABLE INJURY?



Abstract

To provide short- term follow-up data on the surgical success and patient outcome following early anterior cervical fusion in this particular type of injury. A prospective study of 10 consecutive patients.

Stage I compressive extension injury of the cervical spine, as described by Allen and Ferguson, is not always a stable injury. The combined unilateral failure of the posterior structures under compression together with failure of the anterior structure under tension will lead to a rotationally unstable segment. Various treatment options are available including halo vest immobilization, posterior stabilization with plating and anterior fusion and plating.

10 consecutive patients diagnosed with stage I compressive extension injury (fracture subluxation of the cervical spine). All subjects presented with a neurological deficit and vertebral subluxation. All patients were investigated with CT scan of the involved segment; in addition 2 patients had MRI scans.

The surgical protocol consisted of early reduction followed by anterior cervical fusion using a tricortical iliac graft, and stabilization, using locking plate fixation. Follow-up was by radiographs and clinical examination.

Intraoperative assessment revealed disc injury in all patients. Anatomical realignment was achieved together with a solid fusion in all of the patients. All patients showed improvement in the neurological deficit. One patient remains with some residual weakness in his triceps and another patient required removal of a prominent screw.

Early anterior fusion and plating for this type of injury is a safe procedure

The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom