Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury.
OBJECTIVE
To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.


METHODS
This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF) magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.


RESULTS
There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.


CONCLUSIONS
Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.
Jiang
Tao
T
Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
Ren
Xian-jun
XJ
Wang
Wei-dong
WD
Zhang
Xia
X
Li
Chang-qing
CQ
Hao
Yong
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000601:surgery*; D014711:Vertebral Artery / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000601:surgery*