Roy-Camille Technique for Lateral Mass Fixation in Cervical Spine Facetal Joint Dislocation: A Short Term Outcome Analysis

Sivakumar, A P (2009) Roy-Camille Technique for Lateral Mass Fixation in Cervical Spine Facetal Joint Dislocation: A Short Term Outcome Analysis. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Cervical spine injuries usually occurs secondary to high energy trauma including motor vehicle accident (45%) and fall from height (20%). Less commonly, cervical spine injuries occur during sports activities (15%). Neurological injury occurs in 40% of patients with cervical spine fractures. Spinal cord damage more frequently occurs with lower cervical spine injuries. Early recognition, immobilization, preservation or restoration of spinal cord function, and stabilization are the key to successful management of patients with cervical spine injuries Cervical instability due to trauma is usually from the level of c3 to c7. Neurological deficits are common in these levels Unstable cervical spine injuries with or with out neurological deficit require open reduction. Stabilization is done by using various implants and bone grafting. Implants provide immediate stability, where as bone grafts provide long term stability by achieving intervertebral fusion. AIM: To evaluate applicability, safety, radiologically observed efficacy, neurological out come and complications. MATERIALS AND METHODS: This is a prospective study of 20 cases of unstable subaxial cervical spine injuries at Government General Hospital, Chennai from May 2006 to Sep 2008. Inclusion Criteria - All unstable subaxial cervical spine injuries with facetal joint dislocation were included in this study. Age Incidence- Age of the patients ranged from 19yrs to 60 yrs. Bone Grafts: Autogenous cancellous graft is harvested from posterior iliac crest and nibbled spinous processes were used in all cases. Implants Used: Recon plate (3.5 mm) and cortical screws (14mm into 3.5 mm) were used. RESULTS: Eighty lateral mass screws placed by using Roy-camille technique. The mean follow up was 19 months ranging from 28 to 4 months. 75% of patients had at least 18 month of follow up. All patients showed improved neurological status according to Frankel grading. 50% (10) of patients showed improvement of two Frankel grading. All patients with intact neurology showed no further neurological deterioration. Four patients showed improvement in one Frankel grading. And three patients showed complete recovery. Good recovery shown by patients from Frankel grading C. we found poor recovery is seen in C7, C8, and TI involvement which supplies small muscles of the hand. CONCLUSION: Lateral mass fixation by using Roy-camille technique provide adequate fixation for most patterns of cervical instability Roy-camille technique is the safest technique with least incidence of injury to the nerve root and vertebral artery Roy-camille technique offers better biomechanical stability to the traumatic lower cervical spinal injury. Lateral mass fixation with plates and screws should have supplement of bone grafting for better biomechanical stability. In properly selected patients, Lateral mass fixation by using Roy-camille technique doesn’t require additional anterior stabilization. Roy-camille technique doesn’t require any special instruments. Patient can be moblilsed early with minimal external orthrosis after the surgery with minimal complications A simple, easy and cost effective procedure permits early mobilization and prevents complications with out any neurological complications.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Roy-Camille Technique ; Lateral Mass Fixation ; Cervical Spine Facetal Joint Dislocation ; Short Term Outcome Analysis.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Sep 2017 02:31
Last Modified: 14 Sep 2017 02:46
URI: http://repository-tnmgrmu.ac.in/id/eprint/3088

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