[Single-stage combined anterior-posterior stabilization and fusion for superior and distant cervical spine fractures].

OBJECTIVE

To evaluate the applicability and safety of single-stage combined anterior-posterior stabilization and fusion for superior and distant cervical spine fracture.

METHODS

Ten patients with superior and distant cervical spine fracture and/or dislocation aged 30 approximately 68, 8 males and 2 females, underwent single-stage combined anterior-posterior stabilization and fusion. For most cases, especially those whose inferior cervical fracture was without complete bilateral lock of small joints, anterior procedures were performed, including subtotal corpectomy or diskectomy and allograft iliac crest and plates placement, prior to the posterior procedures. For those cases with unstable superior cervical fracture and inferior cervical fracture with bilateral lock of small joints, posterior procedures, including the application of Apofix or Atlas instruments to reposition the atlanto-axial joint, were performed prior to anterior procedures. A hard cervical collar was used postoperatively in all patients. All patients were followed up for 29 months on average.

RESULTS

Satisfying fusion and reduction was obtained in all 10 patients (100%). There were no cases of nerve root injury, strut graft extrusion, or plate or screw looseness or fracture.

CONCLUSION

The combined single-stage anterior-posterior stabilization, reconstruction, and instrumentation procedure represents a viable option in the treatment of a group of patients with superior and distant cervical spine fracture. The technique provides immediate rigid stabilization of the cervical spine, eliminates the need for Halo immobilization or skull distraction and helps begin functional exercise dirigation earlier.