PROGNOSTIC OUTCOME IN SUBAXIAL CERVICAL SPINE INJURIES MANAGEMENT BY ANTERIOR CERVICAL DYNAMIC PLATE WITH CAGE/GRAFT FIXATION AND POSTERIOR CERVICAL LATERAL MASS SCREW-ROD FIXATION METHODS

Abstract

Introduction: The anterior cervical decompression and fusion (ACDF)procedures, especially in cases requiring decompression of two or more levels. Routine use for the treatment of cervical spondylosis has caused plate design to change signicantly in recent years. Aim: To estimate the incidence of sub axial cervical trauma patients admitted in the Neurosurgery wards of the institute. To study the therapeutic outcome after management of the subaxial cervical trauma cases by Anterior cervical decompression (discectomy/corpectomy) with graft or cage and dynamic plate xation, posterior lateral mass screw-rod xation, bidirectional single stage combined approach techniques. To compare anterior dynamic plate graft xation with the posterior lateral mass screw rod xation in cases that could be managed by any single approach. Material and methods: This non randomized prospective observational study was conducted in the Department of Neurosurgery, Mahatma Gandhi Medical College & Hospital, Jaipurfrom April 2018 to December 2019. All diagnosed cases of subaxial cervical spine attending and being admitted to our institute during the study period and treated by anterior cervical decompression with dynamic plate xation, posterior lateral mass screw rod xation or combined technique were included in the study. Result:According to AO Spine Classication Type, 10(20.8%) patients had A2, 15(31.3%) patients had A3, 8(16.7%) patients had A4, 1(2.1%) patient had B2, 13(27.1%) patients had C and 1(2.1%) patient had C,F4. It was found that in Non Severe group, 6(31.6%) patients had A3type in AO Spine Classication Type and in severe group 9(31.0%) patients had A3type in AO Spine Classication Type. In Non Severe group, 4(21.1%) patients had C type in AO Spine Classication Type and in Severe group 9(31.0%) patients had C type in AO Spine Classication Type. The association between AO Spine Classication Type vs ASIAImpairment Scale Group was not statically signicant (p=0.6887). Conclusion:In ASIA IMPAIRMENT SCALE GROUP, 5 SLICS1 was higher [6(31.6%)] in Non Severe group and 8 SLICS1 was higher [9(31.0%)] in Severe group which was not statically signicant (p=0.4820).The mean EQ5D post op at 6month of Non Severe (ASIA IMPAIRMENTSCALE) patients was higher than the Severe group of patients which wasstatically signicant (p=0.0442).