title: [Clinical study of cervical anterior and posterior decompression and internal fixation in the revision of anterior cervical fixation failure].
abstract: OBJECTIVE
  To investigate the clinical effects and prevent the complications of posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure.
  
  
  METHODS
  From 2008 January to 2011 December, 17 patients with cervical anterior internal fixation failure were treated with posterior and anterior decompression and internal fixation. There were 12 males and 5 females, aged from 26 to 68 years old with an average of 44.1 years. The lower screw loosening was found in 6 cases, the upper screw loosening in 5 cases, titanium mesh caving in 3 cases, the upper screw breakage in 2 cases, the lower screw breakage in 1 case. Informations of bone fusion were observed by X-ray, CT, MRI. Clinical effects were evaluated by modified JOA score.
  
  
  RESULTS
  All the revision operations were successfully completed. One case with poor blood coagulation function before operation resulted in postoperative hematoma and occurred neurological symptoms; after hematoma removal and fresh frozen plasma infusion later, neurological symptoms of the patient disappeared. All patients were followed up from 6 to 38 months with an average of (22.4±10.0) months. Postoperative at 2 weeks, 3 months, and final follow-up, JOA score had obviously improved and respectively was 13.1±1.6, 13.4±1.6, 14.2±1.5. All internal fixation locations were good after revision,and obtained bone fusion at 10 months after operation, with an average fusion time of 6 months.
  
  
  CONCLUSIONS
  The combined posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure is safe, can achieve thoroughly decompression, maintain the cervical curvature, reconstruct the three column stability, and it may be used for the patients of cervical anterior fixation failure.
authors.forename: Shao-long
authors.initials: SL
authors.lastname: Tang
authors.forename: Zhao-ming
authors.initials: ZM
authors.lastname: Ye
authors.forename: Qing-hua
authors.initials: QH
authors.lastname: Huang
authors.forename: Wen-hua
authors.initials: WH
authors.lastname: Zhou
authors.forename: Luo-gen
authors.initials: LG
authors.lastname: Wu
authors.forename: Hua-min
authors.initials: HM
authors.lastname: Cao
authors.forename: Da-yong
authors.initials: DY
authors.lastname: Chen
authors.forename: Ye
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged