Standalone Anterior Reconstruction Approach in Traumatic Cervical Spine Instability Lesions

Abstract

Background: The subaxial cervical spine trauma associated with spinal cord injury carries high rate of morbidity, mortality, with  significant socioeconomic impact. There are different modalities for treatment of such cases.

Objective: To evaluate the early outcome of standalone anterior reconstruction cervical spine surgery with cage and plate system in  management of displaced subaxial cervical spine injuries with cord compression.

Patients and Methods: The study included 14 patients during the period from January 2020 to January 2024 with displaced subaxial  cervical spine injuries associated with cord compression. Preoperative symptoms and postoperative results for those patients who  underwent standalone anterior reconstruction of cervical spine by surgery with cage and plate system for treatment of their lesions, were  all recorded.

Results: Patients were 9 males and 5 females with mean age 28 years. The most common cervical level affected was C5-C6 accounting  for (71.5%) 10 cases, followed by C4-C5 3 cases (21.5%) then C6-C7 (7 case). The average blood loss intraoperatively was 150 ml ± 50. The  most common complication was the C5 palsy occurred in 4 cases who improved with medical treatment and follow up. No CSF leak,  hardware failure, vascular injury or soft tissue injuries were reported in this series.

Conclusion: Performing immediate intraoperative  closed reduction under general anesthesia for subaxial cervical spine dislocations, along with anterior cervical stabilization using a cage  and plate system, has been shown to be the preferred treatment option due to its high safety and efficacy rates, with fewer  complications.