Treatment of lower cervical fracture and dislocation with internal fixation

Objective To investigate the effects of decompression and internal fixation for the treatment of the severe fracture and dislocation of the lower cervical spine.Methods Totally 46 cases (30 males,16 females,aged from 17 to 67 years,mean age 46 years)of the fresh severe fracture and dislocation of the lower cervical spine underwent primary decompression and bone graft fusion and internal fixation through anterior and posterior approaches after traction and closed reduction.The hospitalization duration was 3～12 d,and the follow-up period ranged from 6 to 32 months with average 17 months.The X-ray film was taken periodically for observation of the fusion of the bone grafts and the cervical stability.The Frankel grading was used as the judging criteria for the recovery of the spinal cord function.Results Fusion was found in all 46 cases between 4 and 6 months after the operation with the good cervical stability.No failure of the internal instruments or late cervical re-dislocation was found. Conclusion The safe and satisfactory result can be achieved in the majority of the patients with severe lower cervical fracture and dislocation through preoperative traction and closed reduction.The primary internal fixation through anterior and posterior approaches can offer immediate stability to the injured segments.The technique is of benefit to the patients for the functional recover of the spinal cord.