Functional outcome of anterior decompression and fusion with locking cervical plate in subaxial cervical spine injuries

Dhanagopal, M (2013) Functional outcome of anterior decompression and fusion with locking cervical plate in 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 mortality following trauma.6% of trauma patients have spine injuries of which >50% is contributed by cervical spine injury. Jefferson found that injuries to the cervical spine involve two particular areas : C1-2 and C5-7. Meyer identified C2 and C5 as the two most common level of cervical spine injury. Injuries of the cervical spine produce neurologic al deficit in approximately 40% of patients. Approximately 10% of traumatic cord injuries have no obvious radiographic evidence of vertebral injury. Early recognition, immobilisation, preservation 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 and dislocation. AIM: To analyse the Functional outcome of patients treated with “Anterior decompression and fusion with Locking cervical plate in sub axial cervical spine injuries” at Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Madras Medical College from November 2011 to October 2012. MATERIALS AND METHODS: This is a prospective study of 40 cases of subaxial cervical spine injuries treated at Rajiv Gandhi Government Hospital, Chennai from November 2011 to October 2012.The study was done with clearance from Hospital ethical committee. Informed consent was obtained from all the patients. Inclusion Criteria - Age more than18 years and less than 60 years. - All subaxial cervical spine injuries including fractures, subluxations, traumatic disc prolapses with more than one column involvement included in this study. Exclusion Criteria - Age less than18 and more than 60 years. Patients with associated injuries. Patients with severe comorbid conditions. RESULTS: Results were analysed during follow up using following Criteria: 1) Pain, 2) Neurologic recovery, 3) Fusion rate, 4) Stability of spine. In this study most of the cases were in the age group of 41-50 years.  There was male predominance in this case.  Road traffic accident is most common mode of injury followed by fall from height.  Most of the injuries presented within 24 hours of injury.  Most of the patients presented with incomplete neurological deficit.  C5C6 subluxation with disc bulge was the most common spinal injury.  5 patients were operated more than 2 levels. Rest of the patients were operated at 2 levels.  Mean duration of fusion was 15 weeks.  Mobilisation of neck started after 6 weeks. CONCLUSION: The use of anterior cervical plating after anterior corpectomy and fusion with autologous bone graft greatly enhances arthrodesis. Locking cervical plate provides rigids tabilisation. Therefore we consider that the Anterior decompression and fusion with locking compression plate as a viable procedure in subaxial cervical spine injuries.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Functional outcome ; anterior decompression ; fusion ; locking cervical plate ; subaxial cervical spine injuries.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Sep 2017 03:32
Last Modified: 14 Sep 2017 03:32

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