Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 843-847
DOI: 10.4103/ajns.AJNS_331_17
Original Article

Subaxial cervical spine injuries: Outcomes after anterior corpectomy and instrumentation

Ankit Madan
Department of Orthopaedics, Indira Gandhi Medical College, Shimla, Himachel Pardesh
,
Manoj Thakur
Department of Orthopaedics, Indira Gandhi Medical College, Shimla, Himachel Pardesh
,
Sachin Sud
Department of Orthopaedics, Indira Gandhi Medical College, Shimla, Himachel Pardesh
,
Vaibhav Jain
Department of Orthopaedics, Indira Gandhi Medical College, Shimla, Himachel Pardesh
,
Rudra Singh Thakur
Department of Orthopaedics, Indira Gandhi Medical College, Shimla, Himachel Pardesh
,
Virender Negi
Department of Orthopaedics, Indira Gandhi Medical College, Shimla, Himachel Pardesh
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Study Design: This is prospective study. Purpose: The purpose of this study is to assess the functional, neurological, and radiological outcomes of the patients of subaxial cervical spine injuries treated by anterior corpectomy and stabilization with anterior cervical locking plate and cage filled with bone. Overview of the Literature: The principles in the treatment of unstable cervical spine injuries are reduction and stabilization of the injured segment, maintenance of cervical lordosis and decompression where indicated and ranges from nonoperative to combined anterior and posterior surgical fusion. There is, however, debate on the indications for anterior, posterior, or combined surgery. Materials and Methods: The present study of 99 patients includes prospective patients of subaxial cervical spine injuries between February 2014 and February 2016 admitted and operated to Indira Gandhi Medical College, Shimla. Bony fusion, neurological recovery, Neck Disability Index and complication were studied in all patients. The mean follow-up period was 27 months (range 12–42 months). Results: Of the 99 procedures, 77 (77.8%) involved a single vertebral level, 19 (19.2%) involved two levels, and 3 (3%) involved three levels corpectomy. The mean Neck Disability Index was 7.57 ± 5.42. Definitive Bridwell Grade 1 fusion was seen in 64.6% of the cases. No deterioration of neurological symptoms was seen. Dysphagia was the most common complication in 79 (79.8%) patients. One patient had minimal screw back out. Conclusions: Anterior cervical corpectomy and stabilization with cage filled with bone and cervical reflex locking plate are good method for subaxial cervical spine injuries with good fusion rates and probably procedure of choice for posttraumatic multiple disc prolapse with reduced hazards of multiple grafts.

Key-words:

Corpectomy - fusion - neck disability index - subaxial cervical spine injuries

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Torretti JA, Sengupta DK. Cervical spine trauma. Indian J Orthop 2007;41:255-67.
  • 2 Goldberg W, Mueller C, Panacek E, Tigges S, Hoffman JR, Mower WR, et al. Distribution and patterns of blunt traumatic cervical spine injury. Ann Emerg Med 2001;38:17-21.
  • 3 Park HW, Lee JK, Moon SJ, Seo SK, Lee JH, Kim SH, et al. The efficacy of the synthetic interbody cage and Grafton for anterior cervical fusion. Spine (Phila Pa 1976) 2009;34:E591-5.
  • 4 Wang JC, McDonough PW, Endow KK, Delamarter RB. Increased fusion rates with cervical plating for two-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 2000;25:41-5.
  • 5 Bohlman HH, Emery SE, Goodfellow DB, Jones PK. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am 1993;75:1298-307.
  • 6 Cauthen JC, Kinard RE, Vogler JB, Jackson DE, DePaz OB, Hunter OL, et al. Outcome analysis of noninstrumented anterior cervical discectomy and interbody fusion in 348 patients. Spine (Phila Pa 1976) 1998;23:188-92.
  • 7 Koller H, Reynolds J, Zenner J, Forstner R, Hempfing A, Maislinger I, et al. Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries. Eur Spine J 2009;18:630-53.
  • 8 Gelb DE, Aarabi B, Dhall SS, Hurlbert RJ, Rozzelle CJ, Ryken TC, et al. Treatment of subaxial cervical spinal injuries. Neurosurgery 2013;72 Suppl 2:187-94.
  • 9 Aebi M, Zuber K, Marchesi D. Treatment of cervical spine injuries with anterior plating. Indications, techniques, and results. Spine (Phila Pa 1976) 1991;16:S38-45.
  • 10 Dai L, Jia L. Central cord injury complicating acute cervical disc herniation in trauma. Spine (Phila Pa 1976) 2000;25:331-5.
  • 11 Goffin J, Plets C, Van den Bergh R. Anterior cervical fusion and osteosynthetic stabilization according to Caspar: A prospective study of 41 patients with fractures and/or dislocations of the cervical spine. Neurosurgery 1989;25:865-71.
  • 12 Hirsh LF, Duarte LE, Wolfson EH, Gerhard W. Isolated symptomatic cervical spinous process fracture requiring surgery. Case report. J Neurosurg 1991;75:131-3.
  • 13 Joaquim AF, Patel AA, Vaccaro AR. Cervical injuries scored according to the subaxial injury classification system: An analysis of the literature. J Craniovertebr Junction Spine 2014;5:65-70.
  • 14 Hadley MN, Walters BC, Grabb PA, Oyesiku NM, Przybylski GJ, Resnick DK, et al. Guidelines for the management of acute cervical spine and spinal cord injuries. Clin Neurosurg 2002;49:407-98.
  • 15 Lemons VR, Wagner FC Jr. Stabilization of subaxial cervical spinal injuries. Surg Neurol 1993;39:511-8.
  • 16 Vasan T. Circumferential fusion for sub-axial cervical spine fracture – Subluxations. The Indian J Neurotrauma 2007;4:65-70.
  • 17 Uribe JS, Sangala JR, Duckworth EA, Vale FL. Comparison between anterior cervical discectomy fusion and cervical corpectomy fusion using titanium cages for reconstruction: Analysis of outcome and long-term follow-up. Eur Spine J 2009;18:654-62.