Single-stage combined anterior-posterior instrumentation for multiple level cervical spine fractures

Abstract

To investigate the efficacy of single-stage combined anterior-posterior instrumentation for treatment of multiple level cervical spine fractures. Nine patients with multiple-level fractures of the cervical spine, 8 males and 1 female aged 24 - 63, underwent ingle-stage combined anterior-posterior instrumentation. Seven patients with multiple contiguous fractures of the cervical spine were treated with anterior decompression and plating combined with posterior cervical lateral mass screw fixation; and 2 patients with non-contiguous cervical fractures, both with type II odontoid fracture and lower cervical fracture, were treated with both anterior odontoid screw and posterior cervical lateral mass screw fixation. Cranioskeletal traction with a weight of 5 kg was done before the operation. Follow-up was conducted for 31 months. ASIA motor scores were used to evaluate the neural function. Satisfactory reduction and fusion were obtained without any complication, and the neural function was improved. Nerve root function recovered in two patients and one patient's spinal cord function became normal. The average ASIA score was 63.8. A feasible option in the treatment of multiple level cervical spinal fractures, single-stage combined anterior-posterior instrumentation provides decompression and stabilization in a short time and helps the neural function to recover.