Operative Treatment of Lower Cervical Spinal Injury:Metal Internal Immobilization

Cho, B S; Park, H S; Kim, S Y; Rhee, D Y

Abstract

The purpose of treatment in lower cervical spinal injuries are maintenance of spinal stability and neural decompression. Anterior and posterior intervertebral body fusion have been advocated by various authors for management of several varieties of fracture and fracture-dislocation of the lower cervical spine. Recently, internal immobilization with osteosynthetic plate and screw is widely used. The authors approached anteriorly or posteriorly with consideration of radiological findings and injury mechanisms. Of these total 20 cases, anterior fusion was done 14 cases, posterior fusion in 3 cases and decompressive laminectomy in 3 cases. Cervical body plate was used in 14 cases, interlaminar clamp in 3 cases. The results were as follows ; 1) The 12 of 20 patients showed neurological improvement at discharge. 2) Early ambulation with Philadelphia brace was possible in all 17 cases of cervical body plate and interlaminar clamp. 3) The one case of cerebrospinal fluid leakage resulted from dura tearing due to screw fixation, and 1 case of death was due to pneumonia, who was admission grade A and was treated by decompressive laminectomy only. 4) All but expired case did not show spinal deformity and nonunion.