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Distractive flexion injuries of the subaxial cervical spine treated with anterior plate alone
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
2004 (English)In: Journal of Spinal Disorders & Techniques, ISSN 1536-0652, E-ISSN 1539-2465, Vol. 17, no 1, 1-7 p.Article in journal (Refereed) Published
Abstract [en]

The clinical and radiographic effect of anterior plate fixation alone was evaluated in 36 consecutive patients with distractive flexion (DF) injuries in the lower cervical spine. Mean follow-up time was 15 months. The aim of the present study was to determine whether anterior plate fixation alone provides sufficient stability when treating DF injuries in the cervical spine. Solid union was seen in 6 of 6 patients with stage 1 injury and in 15 of 17 patients with stage 2 injury. In the patients with stage 3 injury, 7 of 13 of the anterior fixations failed. These failures occurred mainly among the patients with severe neurologic injuries. We believe these findings substantiate the use of anterior plate alone for DF injuries at stage 1 and 2 but disqualify anterior plate fixation alone for DF injuries at stage 3, with neurologic injury present.

Place, publisher, year, edition, pages
2004. Vol. 17, no 1, 1-7 p.
Keyword [en]
Adolescent, Adult, Aged, Bone Plates/standards/*statistics & numerical data, Cervical Vertebrae/*injuries/pathology/radiography, Female, Follow-Up Studies, Humans, Internal Fixators/standards/*statistics & numerical data, Laryngeal Nerves/injuries/physiopathology, Magnetic Resonance Imaging, Male, Middle Aged, Neurosurgical Procedures/*instrumentation/methods, Postoperative Complications/etiology/pathology/physiopathology, Spinal Cord Injuries/pathology/radiography/surgery, Spinal Fusion/*instrumentation/methods, Spinal Injuries/pathology/radiography/*surgery, Traction, Treatment Outcome
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-90829PubMedID: 14734968OAI: oai:DiVA.org:uu-90829DiVA: diva2:163313
Available from: 2003-09-11 Created: 2003-09-11 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Biomechanical and Clinical Aspects on Fixation Techniques in the Cervical Spine
Open this publication in new window or tab >>Biomechanical and Clinical Aspects on Fixation Techniques in the Cervical Spine
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present work is analyzing the general biomechanical aspects of fixation techniques in the upper and lower cervical spine along with clinical implications.

The in vitro biomechanical properties of five different posterior atlanto-axial fixation techniques are compared. They provided for either a one, two or three-point fixation between atlas and axes. A new device, the C1 claw was biomechanically tested, which allow for fixation without the need for a structural bone graft. The three-point reconstructions indicated superior biomechanical properties compared to all others.

The new C1 claw device was clinically evaluated in a series of 26 patients treated with a posterior C1-C2 fusion. There were no clinical or radiological failures in the series, Twenty-one patients out of twenty-three with any length of follow up either showed a solidly healed fusion or a healed fracture.

Distractive flexion (DF) injuries in the lower cervical spine treated with anterior plate alone were analyzed with respect to healing rate and complications in a consecutive series of 36 patients. Results indicated that DF injury stage 1 and 2 according to Allen and Ferguson healed without complication, whereas DF injuries stage 3 had a high frequency of failure, needing an additional posterior fixation.

The in vitro biomechanical properties of four different fixation techniques for a distractive flexion injury stage 3 were analyzed. The result indicated that anterior plate alone for fixation of a DF injury stage 3 is insufficient supporting the clinical finding in the previous study.

Adjacent level motion was analyzed following a one segment fusion in the lower cervical spine. Motion was found to increase in adjacent levels possibly contributing to accelerated degeneration.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 37 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1286
Keyword
Medicine, Biomechanics, Atlanto-axial fusion, Distractive flexion injuries, cervical spine, adjacent level motion, Medicin
National Category
Dermatology and Venereal Diseases
Identifiers
urn:nbn:se:uu:diva-3574 (URN)91-554-5735-5 (ISBN)
Public defence
2003-10-17, Rosénsalen, ingång 95/96, Uppsala, 09:15
Opponent
Supervisors
Available from: 2003-09-11 Created: 2003-09-11Bibliographically approved

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Olerud, ClaesBergman, Antonina

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