Retrospective and Prospective study of Functional Outcome of Cervical Spine Injuries treated with Posterior Stabilization

Vijayaraj, R (2020) Retrospective and Prospective study of Functional Outcome of Cervical Spine Injuries treated with Posterior Stabilization. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: The cervical spine is a highly mobile segment of the spine, liable to variety of diseases and trauma. It is a complex region where many vital structures lie in close proximity to vertebra. Cervical spine injuries due to trauma with neurological deficit like root compression, cord compression are not uncommon. An unstable injury of cervical spine with or without neurological deficit requires open reduction. Lateral mass screws have been advocated by many spinal surgeons for both traumatic and degenerative fixation of the cervical spine Major advantage of posterior stabilization with lateral mass fixation is its higher fusion rate, greater biomechanical stability when compared to anterior plating or interspinous wiring techniques. Injury to nerve root associated with lateral mass screw insertion and screw fixation failure is the main potential complication. The most feared direct complications of LMSF are in-juries to the vertebral arteries and nerve roots. AIM OF THE STUDY: To analyze the functional outcome i.e neurological improvement of patients with traumatic cervical spine injury treated with lateral mass fixation posterior cervical fusion with bone grafting. METHODS: Longitudinal study of 20 patients with traumatic cervical spine injuries in Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General hospital treated with lateral mass fixation and posterior stabilization fulfilling the eligibility criteria .Patient diagnosed with traumatic cervical spine injuries with neurological deficit as per ASIA scoring system. Patients with cervical spine instability by SLIC scale 5 or more. ALLEN and FERGUSON classification of sub axial spine fractures c3 to c7. Patients having proper medical records, motor score at time of admission, MRI reports and images CT reports and images. Age of 18 years and above. DISCUSSION: A sub axial cervical spine injury classification system (SLIC) in which SLIC score 5 or > 5 needs operative management. The treatment of cervical spine fractures and dislocations has several goals, including reduction of the Deformity and stabilization, minimizing or decreasing neurologic injury, and early rehabilitation. Lateral mass screw provides excellent 3 dimensional fixations from C3 to C7, and currently it is also the most commonly performed posterior fixation method. The normal lordotic curve of cervical spine is maintained in all cases. In fresh cases reduction achieved by soft tissue release and traction if needed facet is nibbled. In old cases reduction is not attempted. posterior stabilization and bone grafting gives stabilization and fusion compared to ACDF. CONCLUSION: The ultimate goal of surgical intervention for sub axial cervical spine injuries is stabilization of spine, restoration of spinal anatomy, decompression of neural elements, there by promoting the neurological recovery and early facilitation of rehabilitation. In our study, we achieved good functional outcome following in the form of stability, fusion, neurological improvement if incomplete injury. Proper preoperative planning, precision in surgical techniques and early rehabilitation program are needed in achieving good results and minimizing complications. To conclude that posterior surgical stabilization of sub axial cervical spine injuries had good functional outcome.

Item Type: Thesis (Masters)
Additional Information: 221712012
Uncontrolled Keywords: Functional Outcome, Cervical Spine Injuries, Posterior Stabilization, Retrospective and Prospective study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 13 Feb 2021 13:23
Last Modified: 13 Feb 2021 13:23
URI: http://repository-tnmgrmu.ac.in/id/eprint/14097

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