Reduction, internal stabilization and anterior fusion in subaxial cervical dislocations

Abstract

Introduction: cervical traumatic facet dislocations are frequent and require reduction, by closed or open methods. Surgical reduction can be performed by an anterior, posterior, or combined approach. The conduct to follow is controversial.

Objective: to evaluate the results of reduction, internal stabilization and fusion by anterior approach in subaxial cervical dislocations.

Methods: a non-randomized controlled quasi-experimental study was carried   at the Holguin Clinical Surgical Hospital from November/2016 to August/2019. It worked with the entire population -27 patients- who met the selection criteria. The information was obtained from medical records and surgical reports. Various classifications and scales were used to evaluate the variables under study. Ethical principles were met.

Results: the male sex predominated (88.89 %), the group from 33 to 46 years (33.30 %) and the majority presented neurological lesions (92.60 %), six of them with complete lesions (22.20 %). The most affected level was C5-C6 (48.15 %). In 81.48 % the surgical intervention was performed in the first 24 hours and in 18.52 % within 48 hours. Discectomy was performed in 81.48 % and corpectomy in 18.52 %, both followed by fixation. Preoperative closed reduction was used in 22.22 %. During the fusion follow-up, 66.67 % achieved grade I at three months and 70.07 % at six.

Conclusions: intervention using this type of approach guarantees satisfactory vertebral fusion in the event of type C facet dislocations, without the need for a posterior approach.