title: Immediate reduction under general anesthesia and single-staged anteroposterior spinal reconstruction for fracture-dislocation of lower cervical spine.
abstract: Fracture-dislocation of the lower cervical spine is a severe traumatic lesion, most frequently resulting in tetraplegia. Treatment is usually painful and time consuming. This retrospective study evaluated the clinical curative effect of immediate reduction under general anesthesia and single-staged anteroposterior spinal reconstruction for fracture-dislocation of the lower cervical spine. Twelve cases of traumatic lower cervical spinal fracture-dislocation were retrospectively analyzed from January 2006 to December 2011. The injury level was C4/C5 in 4, C5/C6 in 5, and C6/C7 in 3 patients. The spinal cord function grades according to the American Spinal Injury Association impairment scale (2000 edition amended) before operation were as follows: grade A in 2 cases, grade B in 2 cases, grade C in 5 cases, grade D in 2 cases, and grade E in 1 case. On admission, all patients underwent immediate reduction under general anesthesia and single-staged anteroposterior spinal reconstruction by circumferential fixation/fusion. The spinal cord function grades according to American Spinal Injury Association after operation were as follows: grade A in 1 case, grade B in 1 case, grade C in 3 cases, grade D in 3 cases, and grade E in 4 cases. All 12 patients showed evidence of stability at the instrumented level on the final follow-up examination (mean follow-up, 3.7 y). Immediate reduction under general anesthesia followed by a single-stage combined anteroposterior spinal reconstruction is a safe and reliable way of treating patients with lower cervical spine fracture-dislocations.
authors: *Department of Orthopedics, Xuanwu Hospital, Capital Medical University †Department of Nephrology, General Hospital, Beijing Military Region, Beijing, China.
authors: Yu
authors: Y
authors: Shen
authors: Hui-liang
authors: HL
authors: Shen
authors: Ming-Li
authors: ML
authors: Feng
authors: Wen-Bo
authors: WB
authors: Zhang
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011182:Postoperative Care; D019651:Plastic Surgery Procedures; D016103:Spinal Fractures / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014143:Traction