Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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The Management of Bilateral Interfacetal Dislocation with Anterior Fixation in Cervical Spine : Comparison with Combined Antero-Posterior Fixation

  • Kim, Ki-Hong (Department of Neurosurgery School of Medicine Kyungpook National University) ;
  • Cho, Dae-Chul (Department of Neurosurgery School of Medicine Kyungpook National University) ;
  • Sung, Joo-Kyung (Department of Neurosurgery School of Medicine Kyungpook National University)
  • Published : 2007.10.31
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Abstract

Objective : Combined antero-posterior fixation has been a standard method for bilateral interfacetal dislocation in cervical spine. The purpose of this study is to evaluate the efficacy and complication of anterior cervical stabilization in treatment of bilateral interfacetal dislocation. Methods : A total of 65 cases of traumatic bilateral interfacetal dislocation in cervical spine who were managed in our institution, from Mar. 1997 to Feb. 2006, were included in this study. Closed reduction was tried in all cases before operation. If closed reduction was accomplished successfully, only anterior cervical fixation was performed (Group I), and attempted to place screws bicortically as possible with unicortical screws. If failed, posterior open reduction with fixation was first tried, followed by anterior cervical fixation (Group II). All patients were evaluated for neurological outcome and radiological evidence of healing. Results : The Group I included 47 patients and the Group II, 18 patients. The improvement of Frankel grade and increase of mean cervical lordosis angles were not statistically different between two groups. Screw-plate system used did not influence the outcome. On follow up, solid bone fusion was evident and there were no cases of instability in both groups. Conclusion : Our study demonstrated that anterior cervical fixation on BID is safe and effective in comparison with combined antero-posterior cervical fixation.

Keywords

References

  1. Berrington NR, van Staden JF, Willers JG, Van der Westhuizen J : Cervical intervertebral disc prolapse associated with traumatic facet dislocation. Surg Neurol 40 : 395-399, 1993 https://doi.org/10.1016/0090-3019(93)90219-Q
  2. Choi JY, Yoon DH, Chin DK, Kim YS : Locked Facet Syndrome of the Cervical Spine. J Korean Neurosurg Soc 26 : 1379-1384, 1997
  3. Coe JD, Warden KE, Sutterlin CE, McAfee PC : Biomechanical evaluation of cervical spinal stabilization methods in a human cadaveric model. Spine 14 : 1122-1131, 1989 https://doi.org/10.1097/00007632-198910000-00016
  4. De Iure F, Scimeca GB, Palmisani M, Donati U, gasbarrini A, Bandiera S, et al : Fracture and dislocations of the lower cervical spine : surgical treatment. A review of 83 cases. Chir Organi Mov 88 : 397-410, 2003
  5. Do Koh Y, Lim TH, Won You J, Eck J, An HS : A biomechanical comparison of modern anterior and posterior plate fixation of cervical spine. Spine 26 : 925-939, 2001
  6. Grant GA, Mirza SK, Chapman JR, Winn HR, Newell DW, Jones DT, et al : Risk of early closed reduction in cerical spine subluxation injuries. J Neurosurg 90 : 13-18, 1999
  7. Hadley MN, Fitzpatrick BC, Sonntag VK, Browner CM : Facet fracture-dislocation injuries of the cervical spine. Neurosurgery 30 : 661-666, 1992 https://doi.org/10.1227/00006123-199205000-00001
  8. Jin DD, Lu KW, Wang JX, Chen JT, Jiang JM : The selection of the surgical approach in the management of fracture and dislocation of lower cervical spine combined spinal cord injury. Zhonhua Wai Ke Za Zhi 21 : 1303-1306, 2004
  9. Johnson MG, Fisher CG, Boyd M, Pitzen T, Oxland TR, Dvorak MF : The radiographic failure of single segment anterior cervical plate fixation in traumatic cervical flexion distraction injuries. Spine 29 : 2815-2820, 2004 https://doi.org/10.1097/01.brs.0000151088.80797.bd
  10. Jung ES, Ko SK, Kim OL, Chi YC, Choi BY, Cho SH : Internal Fixation of the Unstable Cervical Spine Fracture and Subluxation. J Korean Neurosurg Soc 21 : 36-41, 1992
  11. Kim SM, Lim TJ, Paterno J, Park J, Kim DH : A biomechanical comparison of three surgical approaches in bilateral subaxial cervical facet dislocation. J Neurosurg Spine 1 : 108-115, 2004 https://doi.org/10.3171/spi.2004.1.1.0108
  12. Lehmann W, Blauth M, Briem D, Schmidt U : Biomechanical analysis of anterior cervical spine plate fixation systems with unicortical and bicortical screw purchase. Eur Spine J 13 : 69-75, 2004 https://doi.org/10.1007/s00586-003-0578-z
  13. Lukhele M : Fractures of the vertebral lamina associated with unifacet and bifacet cervical spine dislocations. S Afr J Surg 32 : 112-114, 1994
  14. Lu K, Lee Tc, Chen HJ : Closed reduction of bilateral locked facets of the cervical spine under general anaesthesia. Acta Neurochir (Wien) 140 : 1055-1061, 1998 https://doi.org/10.1007/s007010050214
  15. Ordonez BJ, Benzel EC, Naderi S : Cervical facet dislocation : technique for ventral reduction and stabilization. J Neurosurg 92 : 18-23, 2000
  16. Pan HC, Huang CI, Chen MT, Lee LS : Anterior cervical stabilization with the synthes cervical spine locking plate system. Zhoughua Yi Xue Za Zhi (Taipei) 62 : 852-858, 1999
  17. Payer M : Immediate open anterior reduction and antero-posterior fixation/fusion for bilateral cervical locked facets. Acta Neurochir (Wien) 147 : 509-514, 2005 https://doi.org/10.1007/s00701-004-0462-6
  18. Razack N, Green BA, Levi AD : The management of traumatic cervical bilateral facet fracture-dislocation with unicortical anterior plates. J Spinal Disord 13 : 374-381, 2000 https://doi.org/10.1097/00002517-200010000-00002
  19. Reindl R, Ouellet J, Harvey EJ, Berry G, Arlet V : Anterior reduction for cervical spine dislocation. Spine 31 : 648-652, 2006 https://doi.org/10.1097/01.brs.0000202811.03476.a0
  20. Sonntag VK : Management of bilateral locked facets of the cervical spine. Neurosurgery 8 : 150-152, 1981 https://doi.org/10.1227/00006123-198102000-00002
  21. Toh E, Nomura T, Watanabe M, Mochida J : Surgical treatment for injuries of the middle and lower cervical spine. International Orthopaedics 30 : 54-58, 2006 https://doi.org/10.1007/s00264-005-0016-4
  22. Vital JM, Gille O, Senegas J, Pointillart V : Reduction technique for uni- and biarticular dislocations of the lower cervical spine. Spine 23 : 949-954, 1998 https://doi.org/10.1097/00007632-199804150-00021
  23. Wolf A, Levi L, Mirvis S, Ragheb J, Huhn S, Rigamonti D, et al : Operative management of bilateral facet dislocation. J Neurosurg 75 : 883-890, 1991 https://doi.org/10.3171/jns.1991.75.6.0883
  24. Woodring JH, Goldstein SJ : Fractures of the articular processes of the cervical spine. AJR Am J Roentgenol 132 : 341-344, 1982