Anterior reduction and fixation for lower cervical fracture

Objective To explore the effect of anterior reduction and fixation for treating lower cervical fracture.Methods A retrospective review was made in 27 lower cervical fractures.Without perioperative traction,all patients were treated by anterior reduction,autogenous iliac bone graft,and cervical spine locking plate fixation.The bone graft fusion rate and maintenance of intervertebral height were observed.All the cases were evaluated according to Frankel criteria of the neurol function preoperatively,and 12 months after operation.Results 27 cases were followed up,and the average period of follow-up was 27.3 months.The fusion rate was 100%,and the intervertebral height and the physiological curve of cervical spine were no significant different between two time points after operation.No deterioration of neurological injury or operation associated complication was observed.According to Frankel grading system,among the 27 patients with low cervical fracture,1 at Grade A got no improvement;4 at Grade B were improved to Grade C in 2 and D in 1,and 1 got no improvement;6 at Grade C were improved at Grade D in 4 and 2 at Grade E in 2;14 at Grade D were restored to E in 11,and 3 got no improvement.2 at Grade E remained in Grade E.Conclusions Anterior operation is a safe and effective procedure for treatment of cervical fracture.Using cervical spine locking plate in low cervical fracture can increase the fusion rate of the bone graft and maintain the intervertebral height and physiological curve of cervical spine.It is important to select a suitable surgical approach according to different types of cervical fracture and dislocation.