The cervical spine column is extremely vulnerable to injury due to its specific facet joint articulation. The most serious complication quadriplegia occurs in almost 40to50% of cases. Surgery is indicated if signs of instability, significant dislocation or neurological deficit are present. Over the last 15 years, the anterior approach has become the gold standard.
Aim of Study: To evaluate the functional, clinical and radiographic results of traumatic cervical spine instability which were treated surgically using Cervical Spine Locking Plate (CSLP) fixation and anterior interbody fusion with tricortical iliac crest bone graft.
Materials and Methods: This is a prospective and retrospective study 23 Patients who attended the Orthopaedics casualty Medical College Kozhikode, with traumatic quadriplegia due to lower cervical spine injury who were treated with anterior cervical locking plate during a period of 2 years from June 2010 onwards were studied. The outcome of the treatment was compared in terms of relief of symptoms, neurological recovery, clinical and radiological stability and improvement of rehabilitation. The cases were followed up for 2 years from the beginning of the treatment.
Analysis and Results: The following observations were made from this study. The youngest patient in the study was 16 and the oldest 65 years. The most common level of injury in this study was C5-C6 (11 patients), Only 9 patients were treated within 72 hours. Neurological recovery was evaluated by preoperative and postoperative FRANKEL and ASIA scores. All patients were densely quadriplegic before surgery, 6 patients had no change in neurology and expired in postoperative period. Excellent neurological recovery was seen in only minimal number of patients. In the postoperative period, for functional outcome measurement, patients were evaluated using modified ODOMS criteria. Out of all the patients, 13 had good fusion status.
Conclusion: The ideal management of traumatic cervical spine instability in lower cervical spine injury is anterior stabilization with cervical spine locking plate. The surgery related complications are relatively very less, and the survived patients had significant improvement in their neurological and functional status All the patients had good radiological fusion and no complications in union.