Anterior-posterior operation with posteriorly limited fixation for the irreducible old dislocation of the inferior cervical vertebra combined with tiny joint interlocking

Objective: To investigate the clinical outcome and application value of single stage circumferential surgery for irreducible old dislocation of the inferior cervical vertebra combined with tiny joint interlocking.

Methods: From Mar. 2004 to Aug. 2010,18 patients with old dislocation of the inferior cervical vertebra, in which 16 showed double joint interlocking and the others 2 showed single by the three dimensional CT scan. MRI showed that all patients had intervertebral disc injury including intervertebral disc rupture (9 cases), intervertebral disc herniation (2 cases) and the fracture of inferior cervical vertebra accompanying with intervertebral disc rupture (7 cases). All patients were treated with anterior-posterior operation with posteriorly limited fixation. Stability and fusion rate of injury segment were observe by X-ray and CT scan;function of spinal cord was assessed by Frankel grade criteria.

Results: All patients were followed up from 6 to 12 months with an average of 8.6 months. Dislocation of cervical vertebra got complete reduction and all grafts got fusion. There was no complication of internal fixation breakage, loosening ,displacement and there was no injury of blood vessel, nerve, esophagus during the operation. No function of spinal cord got worse after operation and the function improved by 1.2 grades in average in Frankel grade.

Conclusions: Single stage circumferential surgery in treating irreducibly old dislocation of inferior cervical vertebra combined with tiny joint interlocking can complete recover the sequence of the cervical vertebra and relieve the compression of spinal cord and can obtain postoperative immediate stability for injury segment and will not aggravate the injury of the spinal cord and may create beneficial condition for functional recovery of the spinal cord.