COMBINED ANTERIOR FUSION FOR CERVICAL SPINE INJURY

Abstract

Objective. Substantiation of combined fixation utilizing anterior cervical plates and porous implants for unstable cervical spine injury. Material and Methods. Sixty-five patients (mean age of 31.3 years) were operated on for complicated and noncomplicated cervical spine injuries. Out of them there were 53 (81.5 %) men and 12 (18.5 %) women. Patients were grouped according to mechanisms of injury and terms of admission to the hospital. Isolated interbody fusion or combined fusion with anterior plate was performed depending on the degree of instability. Outcome assessment included a dynamics of neurologic regression, reconstruction of a spine axis (according to X-ray and CT data), and in some cases the spinal cord was assessed with CT and MRI. Results. Complete spinal cord injury resulted in death of 5 patients despite complete decompression and rigid fixation of the injured segment, at discharge 14 patients had neurologic status of type A (ASIA scale), and 4 patients moved to type B. Patients with incomplete spinal cord injury demonstrated the following outcomes: in group of patients with type B neurologic deterioration 4 patients improved to type C and 2 – to type D; in type C group 5 patients improved to type D and 5 – to type E; in type D group 5 patients improved to type E. Conclusion. Combination of interbody fusion with anterior plate fixation significantly augments the reliability of fixation, permitting to avoid external immobilization and to activate patients earlier, which finally improves neurologic prognosis and provides favorable conditions for bone-metal block formation.