title: Comparison of the technique of anterior cervical distraction and screw elevating-pulling reduction and conventional anterior cervical reduction technique for traumatic cervical spine fractures and dislocations.
abstract: BACKGROUND
  To analyze and confirm the advantages of anterior cervical distraction and screw elevating-pulling reduction which are absent in conventional anterior cervical reduction for traumatic cervical spine fractures and dislocations.
  
  
  METHODS
  A retrospective study was conducted on 86 patients with traumatic cervical spine fractures and dislocations who received one-stage anterior approach treatment for a distraction-flexion injury with bilateral locked facet joints between January 2010 and June 2015. They were 54 males and 32 females with an age ranging from 20 to 73 years (average age, 40.1 ± 5.6 years). These patients were distributed into group A and group B in the sequence of visits, with 44 cases of conventional anterior cervical reduction (group A) and 42 cases of anterior cervical distraction and screw elevating-pulling reduction (group B). Comparison of intraoperative blood loss, operation duration and vertebral reduction rate was made between the two groups. The follow-up time was 12-18 months, and the clinical outcomes of surgery were evaluated according to ASIA score, VAS score and JOA score.
  
  
  RESULTS
  Statistically significant difference was revealed between group A and group B in the surgical time and the correction rate of cervical spine dislocation (p < 0.05), with the results of group B better than those of group A. For the two groups, statistically significant difference was shown between the ASIA score, VAS score and JOA score before and after operation (p < 0.05), with the results better after operation, while no statistically significant difference was revealed in such scores between the two groups (p > 0.05), with the therapeutic effect of group A the same with that of group B.
  
  
  CONCLUSIONS
  Anterior cervical distraction and screw elevating-pulling reduction is simple with low risk, short operation duration, good effect of intraoperative vertebral reduction and well-recovered function after the operation. Meanwhile, as a safe and effective operation method for cervical spine fractures and dislocations, it can reduce postoperative complications and the risk of the iatrogenic cervical spinal cord injury caused by prying or facet joint springing during conventional reduction, having more obvious advantages compared to the conventional surgical reduction adopted by group A, with good cervical spine stability as shown in long-term follow-up. Therefore, it is suitable for clinical promotion and application.
authors.affiliation: Dept. of Spine Surgery, Shanghai East Hospital, Tongji University, 150 Jimo Rd., Shanghai 200120, China.
authors.forename: Haoxi
authors.initials: H
authors.lastname: Li
authors.affiliation: Dept. of Spine Surgery, Shanghai East Hospital, Tongji University, 150 Jimo Rd., Shanghai 200120, China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Dept. of Orthopaedic Surgery, 303th Hospital of PLA, Nanning 530021, China.
authors.forename: Changzhi
authors.initials: C
authors.lastname: Cheng
authors.affiliation: Dept. of Orthopaedic Surgery, 303th Hospital of PLA, Nanning 530021, China. Electronic address: volvo900@sina.com.
authors.forename: Zhoudan
authors.initials: Z
authors.lastname: Lin
authors.affiliation: Dept. of Spine Surgery, Shanghai East Hospital, Tongji University, 150 Jimo Rd., Shanghai 200120, China. Electronic address: eastspine@yahoo.com.
authors.forename: Desheng
authors.initials: D
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery; D005260:Female; D000072039:Fracture Dislocation / Q000601:surgery*; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D055815:Young Adult
keywords: Cervical spine; Dislocation; Distraction; Elevating-pulling reduction; Fracture; Neurological deficits