title: Fusion or stabilization alone for acute distractive flexion injuries in the mid to lower cervical spine?
abstract: Long-term pain problems and residual restricted mobility were evaluated for patients sustaining acute distractive flexion injuries to the cervical spine. To assess which of two alternative surgical approaches gives better long-term outcomes, 58 patients were studied, 29 in each group. The results of posterior wire stabilization without fusion according to Brandt were contrasted with those of the Cloward technique. We found significantly more late pain problems and restricted neck mobility in the group treated with wiring without fusion than in those managed with anterior fusion. We conclude that this continuing pain may be due to residual mobility in the damaged degenerated non-fused motion segment, and that the difference between the two groups may reflect the difference in the quality and rate of fusion achieved by the two surgical approaches.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital, Lund, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Feldborg Nielsen
authors.forename: M
authors.initials: M
authors.lastname: Annertz
authors.forename: L
authors.initials: L
authors.lastname: Persson
authors.forename: H
authors.initials: H
authors.lastname: Wingstrand
authors.forename: H
authors.initials: H
authors.lastname: Säveland
authors.forename: L
authors.initials: L
authors.lastname: Brandt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001864:Bone Wires; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome