The surgical treatment of late instability of flexion-rotation injuries in the lower cervical spine.

The authors reviewed 12 cases of anterior dislocation of the lower cervical spine due to flexion-rotation trauma, with late instability after closed treatment. The 12 patients were treated at the Instituto Ortopedico Rizzoli between 1977 and 1982. Epidemiology, causes, type of lesion, and associated complications were studied. After an average period of 3 years (range: 2-6), correction appeared stable in all of the patients. In 4 patients, posterior stabilization with plates was performed after presurgical correction in a halo-thoracic cast. In 4 patients, reduction with combined, treatment consisting of anterior release and posterior stabilization with plates was performed after failure of presurgical correction. Finally, in 4 patients, stabilization was obtained with anterior fusion alone without reduction of the dislocation.