Fracture-dislocations of the cervical spine. Instability and recurrent deformity following treatment by anterior interbody fusion.

Anterior intervertebral-body fusion has been advocated by various authors for management of several varieties of fracture and fracture-dislocation of the cervical spine. This report is a retrospective study of sixteen patients, all of whom had a fracture-dislocation of the cervical spine, who were treated with an anterior dowel interbody fusion. All had postoperative instability with recurrence of angular deformity, and all sixteen were shown to have disruption of the posterior ligaments. Three patients had a progressive neurological deficit postoperatively. Thirteen patients required two or more operative attempts at stabilization. Anterior fusion should not be performed as primary surgical treatment for fractures of the cervical spine when there is either evidence of disruption of the posterior ligaments or a strong presumption that such disruption exists.