Anterior reduction for cervical spine dislocation.
METHODS
Retrospective analysis of a prospectively followed cohort.


OBJECTIVE
Long-term evaluation of patients with anterior stabilization for dislocations of the cervical spine.


METHODS
Level 1 trauma center.


BACKGROUND
Anterior stabilization of unstable cervical spine injuries is gaining popularity. However, the method of open reduction is controversial.


METHODS
Forty-one consecutive patients with unstable dislocations/subluxations of the subaxial cervical spine were included. Closed reduction was attempted in all patients using Gardner-Wells traction. If this failed, an anterior open reduction was performed. Tricortical iliac crest autograft and anterior plating was used. Patients were assessed for: 1) rate of successful reduction and stabilization using only the anterior surgical approach; and 2) complications and long-term clinical and radiologic outcome.


RESULTS
Two of eight (25%) anterior open reductions failed requiring posterior surgery. One of these patients had associated pedicle fractures with horizontal rotation of the lateral masses. All grafts had healed successfully at the most recent follow-up visit. Moderate neck discomfort was found in 5 of 41 patients. Significant neurologic improvement was observed.


CONCLUSIONS
Most subluxations/dislocations of the subaxial cervical spine can be reduced using Gardner-Wells traction and successfully stabilized with anterior surgery alone. If closed reduction fails, anterior open reduction is successful in the majority of cases.
McGill University Health Center, Montreal, Quebec, Canada. rudy.reindl@muhc.mcgill.ca
Rudy
R
Reindl
Jean
J
Ouellet
Edward J
EJ
Harvey
Greg
G
Berry
Vincent
V
Arlet
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000379:methods; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000601:surgery*