Comparison of Anterior, Posterior, and Combined Surgical Approaches on the Outcomes of Patients Suffering from Subaxial Cervical Spine Injuries.

Objective: To investigate the radiological and clinical outcomes of different surgical approaches in cervical spinal trauma in northeastern of Iran.

Methods: The present study was conducted retrospectively from January 2011 to December 2017 in Mashhad, Iran. The demographic characteristics, hospitalization duration, and patient's surgery detail data were extracted from the patients' medical records. The follow-up period was at least six months after surgery.

Results: This study was conducted on 72 patients and the majority (n=51; 70.8 %) of them were male. Moreover, the participants; mean age was determined at 40.7±16.5 years. In total, 33 (45.8%), 13(18.1%), and 11 patients (15.3%) were operated using the anterior, posterior, and combined approaches in one round, respectively. It should be mentioned that 15 (20.8%) patients underwent the combined approach in two rounds. Early mortality was observed in 22 (30.6%) patients in the admission period. According to the follow-up X-ray results, the type of approach showed no relationship with non-fusion, malalignment, cage subside, and adjacent disk narrowing (>0.05).

Conclusion: According to the obtained results, there was no significant association between neurological and radiological outcomes among approaches. A high mortality rate was noted in combined surgery at one round, and the posterior approach is the best option when our goal is to correct lordosis.