Self-made anterior cervical distraction and reduction device for the treatment of lower cervical dislocation with facet locked

Abstract

Objective To explore the feasibility and clinical effect of self-made anterior cervical distraction and reduction device (ACDR) in the treatment of lower cervical dislocation with facet locked. Methods From May 2008 to May 2018 a retrospective analysis was done on 25 cases of lower cervical dislocation combined with facet locked who were treated by self-made anterior cervical distraction and reduction device (ACDR) in Department of Orthopedics, the Second Affiliated Hospital of Bengbu Medical College. There were 16 males and 9 females with a mean age of 45.9 years (range, 25-73 years old). There were 6 cases of unilateral locked facet and 19 cases of bilateral locked facet of lower cervical spine. After successful restoration, anterior intervertebral disc resection and decompression, bone grafting and titanium plate internal fixation were performed. The operative time, intraoperative blood loss, neurological function changes before and after surgery, dislocation correction, average hospitalization days, bone graft fusion and other conditions were recorded to evaluate the surgical efficacy. Results All the 25 patients underwent one stage anatomic reduction and anterior fusion. The operative time was 50-90(79±8.7)min, and intraoperative blood loss was 50-200(130±67)mL, and the hospital stays was 5-13(7±2.1)d. Twenty-two patients were followed up, and the mean follow-up time was 11.5 months (6-24 months), the bone graft and fusion were good, the plates and screws were not loosened, and the nerve function got better in all patients. The JOA score increased from an average of 5.7 points before surgery to 13.6 points at 3 months after surgery. One of the patients developed a transient upper limbs sensorimotor dysfunction and recovered to the preoperative level within 2 weeks. Three patients were left with mild numbness of hands and weak grip strength. Thirteen cases of neurological function recovered to ASIA E grade, 6 cases returned to grade D, and 3 cases returned to grade C. Conclusions ACDR is a safe, effective and reliable surgical tool for the treatment of dislocation of the cervical spine with facet locked patients, and has certain clinical application value. Key words: Spinal fusion; Lower cervical spine; Dislocation; Locked facet; Anterior cervical distraction and reduction device