[Clinical analysis of one-stage posterior-anterior operative approach in treating lower cervical spine fracture and dislocation].

Objective: To investigate the clinical effects of one-stage posterior-anterior decompression and internal fixation for the treatment of the severe fractures and dislocations combined with the spinal cord injuries of the lower cervical spine.

Methods: From August 2005 to August 2009, 48 patients (male 28 and female 20, aged from 28 to 62 years with a mean of 39.6 years) with severe fractures and dislocations of lower cervical spine were treated by reduction and internal fixation with one-stage combined cervical anterior plating and posterior lateral mass screws and rod or plate systems. Frankel grade A was in 8 cases, grade B in 16 cases, grade C in 20 cases, and grade D in 4 cases before operation. Firstly, the posterior approach was carried out. After inserting the mass screws, decompression and reduction were performed, and the rod or plate systems were embedded. After grafting, the skull traction was removed and initiated the anterior reduction, intervertebral decompression, auto-graft and cervical spine auto-locking plate fixation. The stability and fusion rate of the injured segments were evaluated on the regular postoperative X-ray film. The function of the spinal cord was assessed with Frankle classification.

Results: All patients were followed up, ranged from 6 to 28 months with an average of 12 months. Solid fusion obtained in the postoperative 6 months. Frankel grade C was in 28 cases, grade D in 14 cases, grade E in 6 cases after operation. There was no complications related to internal fixation breakage, loosening or displacement. There was no vascular and esophagus complications during the operation.

Conclusion: One-stage combined anterior-posterior decompression and internal fixation in treating severe fracture and dislocations of lower cervical spine could restore the cervical curvature, and obtain good reduction and complete decompression, and gain postoperative immediate stability. This technique is benefit to the patients for the functional recovery of the spinal cord.