Single stage global stabilization for subaxial cervical spine injuries

Ramprasanth, D R (2008) Single stage global stabilization for subaxial cervical spine injuries. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Cervical spine injuries are one of the common causes of serious morbidity and mortality following trauma. 6% of trauma patients have spine injury of which >50% is contributed by cervical spine injury (Rockwood & Green29). Early recognition, immobilisation, preservation or restoration of spinal cord function, and stabilisation are the keys to successful management of patients with cervical spine injuries. Cervical instability due to trauma is usually from the level of C3 to C7 (i.e. subaxial). Neurological deficits are not uncommon i.e.. root compression and cord compression with subluxation or dislocation. Unstable cervical spine injuries with or without neurological deficit require open reduction. Stabilisation is done by using various implants and bone grafting. Implants provide immediate stability, whereas bone grafts provide long term stability by achieving intervertebral fusion. For any fracture in various bones of the body, fixation in polyaxial planes is proven to provide better stability than those done in single plane. Same principle is applied to cervical spine injuries. Both anterior and posterior stabilisation provides better stability than either one alone. AIM: To evaluate Applicability, Safety, Radiologically observed efficacy, Functional outcome, of the procedure. MATERIALS AND METHODS: This is a prospective study of 16 cases of unstable subaxial cervical spine injuries at Government General Hospital, Chennai from May 2006 to October 2007. Inclusion Criteria - All unstable subaxial cervical spine injuries with more than one column involvement were included in this study. Age Incidence - Age of patients ranged from 13 to 59 years. Mean age was 36 years. RESULTS: The results are graded as follows: Good: No neck pain, Clear fusion mass at desired level, Good stability of spine on stress X-rays, Complete or partial neurologic recovery. Fair: Moderate neck pain which does not restrict day to day activities, No recovery of neurologic deficit, Poor fusion mass, Good stability of spine. Poor: Severe neck pain, No recovery or worsening of neurologic deficit, Pseudoarthrosis, Unstable spine. • Pain was absent in all cases, • Neurologic recovery noticed in most cases, • No neurologic deterioration, • Fusion achieved in all cases, • Stability of spine is good in all cases, • So, the grading of results is GOOD in all cases. CONCLUSION: Single stage global stabilisation restores sagittal balance. • Posterior stabilisation first achieves axial alignment than anterior first. • Global stabilisation provides immediate rigid stabilization. • Time taken is much less than staged procedure. • Single anesthetic exposure. • No deterioration of neurology in our study. Therefore we consider single stage combined anterior and posterior stabilisation as a viable option in cervical spine injuries.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Single stage global stabilization ; subaxial cervical spine injuries.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Sep 2017 02:18
Last Modified: 14 Sep 2017 02:18

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