Department of Orthopaedics, Grant Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai, India.
Bangalore Spine Clinic, Bangalore, India.
Br J Neurosurg. 2024 Apr;38(2):418-424. doi: 10.1080/02688697.2021.1885619. Epub 2021 Feb 15.
To describe a single-staged procedure for the management of neglected subaxial cervical spine injuries.
Between January 2012 and December 2014, 12 patients presented to us with healed cervical sub axial dislocations. The deformities could not be reduced using skull traction. Eight were operated with anterior cervical corpectomy. American spinal injury Association (ASIA) grade, Neck Disability index (NDI), and Visual analog scale (VAS) score were recorded throughout the patient course and CT was done at 12 months for assessment of fusion.
Four patients improved from ASIA C to ASIA D, two patients improved from ASIA B to ASIA E, one patient improved from ASIA D to ASIA E and one patient remained static at ASIA B. All patients except one showed evidence of fusion on CT scan at 12 months. NDI improved from preoperative range (18-32, mean 25) to postoperative range (8-16 mean, 11.25), VAS from preoperative range (3-6, mean 4.25) to postoperative range (1-3, mean 1.75).
Single-stage fixation does not disrupt ongoing natural healing and has good clinical and radiological outcomes.
描述一种用于治疗被忽视的下颈椎损伤的单阶段手术方法。
2012 年 1 月至 2014 年 12 月，我们收治了 12 例愈合性颈椎下关节突脱位患者。颅骨牵引无法复位这些畸形。8 例患者行前路颈椎椎体次全切除术。在整个患者病程中记录美国脊髓损伤协会（ASIA）分级、颈椎残障指数（NDI）和视觉模拟评分（VAS），并在 12 个月时行 CT 检查以评估融合情况。
4 例 ASIA C 级患者改善至 ASIA D 级，2 例 ASIA B 级患者改善至 ASIA E 级，1 例 ASIA D 级患者改善至 ASIA E 级，1 例患者保持 ASIA B 级不变。除 1 例患者外，所有患者在 12 个月的 CT 扫描上均显示融合证据。NDI 从术前范围（18-32，平均 25）改善至术后范围（8-16，平均 11.25），VAS 从术前范围（3-6，平均 4.25）改善至术后范围（1-3，平均 1.75）。
单阶段固定不会干扰正在进行的自然愈合，并具有良好的临床和影像学结果。
