Objective: To study the clinical characteristics and treatment of flexion-distraction stage I injuries in subaxial cervical spine.
Methods: Twelve cases of flexion-distraction stage I injuries with delayed symptoms, admitted in our hospital between January 1995 and December 2004, were studied retrospectively. In acute phase, all of 12 cases had neck pain and limited neck movements, neurological deficits were found in 6 of 12 cases. Eight cases had a correct diagnosis, and 2 cases had a error diagnosis, 2 cases missed. All cases were satisfactory by the primary conservative treatment. After 274 days average asymptomatic intervals, all of 12 cases had recurrence of neck pain, delayed neurological deficits were found in 10. MRI showed that all of 12 cases were unstable injuries.
Results: All of the 12 patients were treated operatively. Decompression, fusion and fixation were performed by anterior approach in 9 cases, and by combined anterior and posterior approach in 3 cases. The average follow-up period was 33.1 months. Neck pain had great recovery in all cases, 10 cases with neurological deficits, 7 returned normal. Radiographic evidences of intervertebral bony fusion and good cervical alignment were observed in all of 12 cases.
Conclusions: Flexion-distraction stage I injuries is often caused by ligament and disc injuries, and often missed with subtle symptoms and radiographic changes. Inadequate primary treatment options are often due to failure to recognize the instability, and maybe result in delayed injuries. MRI is helpful for the early accurate evaluation of spinal stability. Unstable injury require early surgical treatment. The anterior approach operation is recommended to most of these patients with acute and old injuries. Combined anterior and posterior approach operation should be considered in these patients who have old injuries with stiff kyphosis.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Assessment of ulnar nerve tension directed towards understanding cubital tunnel syndrome.
J Hand Microsurg
October 2024
Allegheny Health Network, Department of Orthopaedic Surgery, Pittsburgh, PA, USA.
Article Synopsis
- Ulnar nerve compression at the elbow is a common issue, and this study explores how elbow flexion and distraction create tension on the nerve, potentially contributing to the problem.
- Eight upper limb specimens were tested by measuring the tension on the ulnar nerve during elbow flexion and varied distraction levels while manipulating its proximal and distal clamps.
- Results show that tension on the ulnar nerve increased with flexion, distraction, and proximal clamping, with the highest tension observed 4-6 cm below the medial epicondyle.
The importance of the posterior osteoligamentous complex to subaxial cervical spine stability in relation to a unilateral facet injury.
Spine J
July 2012
Division of Orthopaedics, Department of Surgery, Western University, 1151 Richmond St, London, Ontario N6A 5B9, Canada.
Background Context: Unilateral facet disruptions are relatively common in the cervical spine; however, the spectrum of injury is large, and little is known regarding the magnitude of instability expected to be present in an isolated posterior osteoligamentous injury.
Purpose: To quantify the contribution of the posterior osteoligamentous structures to cervical spine stability during simulated flexion-extension (FE), lateral bend (LB), and axial rotation (AR).
Study Design: An in vitro biomechanical study.
Biomechanical evaluation of a low profile, anchored cervical interbody spacer device in the setting of progressive flexion-distraction injury of the cervical spine.
Eur Spine J
January 2013
Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
Introduction: Anterior cervical decompression and fusion is a well-established procedure for treatment of degenerative disc disease and cervical trauma including flexion-distraction injuries. Low-profile interbody devices incorporating fixation have been introduced to avoid potential issues associated with dissection and traditional instrumentation. While these devices have been assessed in traditional models, they have not been evaluated in the setting of traumatic spine injury.
View Article and Find Full Text PDFAnterior cervical discectomy and fusion with a locked plate and wedged graft effectively stabilizes flexion-distraction stage-3 injury in the lower cervical spine: a biomechanical study.
Spine (Phila Pa 1976)
January 2009
Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153, USA.
Study Design: An in vitro three-dimensional (3D) flexibility test of human C3-C7 cervical spine specimens.
Objective: To test the hypothesis that anterior cervical fusion with a wedged graft and a locked plate can effectively stabilize the cervical spine after complete anterior and posterior segmental ligamentous release.
Summary Of Background Data: Distraction-flexion Stage 3 injuries of the lower cervical spine (bilateral facet dislocations) are usually reduced under awake cranial traction.
Posterior instrumentation surgery for thoracolumbar junction injury causing neurologic deficit.
Neurol Med Chir (Tokyo)
January 2008
Department of Neurosurgery, University of South Florida College of Medicine, Tampa, FL, USA.
Thoracolumbar junction (TLJ) injury is one of the most common spine injuries. TLJ injury manifesting as neurologic deficit usually requires surgery because of the underlying spinal instability and/or neural compression. The objectives of surgical treatment are to restore biomechanical stability of the spine and/or to achieve neural decompression.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!