Hyperextension Injury Of Cervical Spine Research Articles

Research on correlative factor of spinal segment distribution in cervical hyperextension injury

Objective To discuss the degenerative factors, the spinal segment distribution, and the mechanism in hyperextension injury of cervical spine. Method Eighty-nine patients with hyperextension injury of cervical spine were retrospectively analyzed by observing the degenerativelesion, the spinal cord segment with high signal in T2WI, and the location of facial trauma. Results Fifty-eight cases showed the disc hemiation which was the most common lesion, followed by 8 cases showing the calcification of the posterior longitudinal ligament. Besides, 7 cases presented the developmental stenosis of spinal canal, and also, 6 cases showed disc hemiation combined with the yellow ligament hypertrophy. The intervertebral level of the spinal cord with high signal in T2WI were distributed as follows:4 cases were at C2/3, of which onesuffered the forehead trauma; 12 cases were at C3/ 4, of which 10 had the forehead trauma, and one had the zygomatic trauma; 12 cases were at C4/5, of which 5 had the forehead trauma, one had both the zygomatic and the forehead trauma, and one had both the forehead and with the lower jaw trauma; 11 cases were at CS/6,of which 3 had the forehead trauma, 3 had the zygomatic trauma, and 2 had the lower jaw trauma. The location of the spinal cord with single high signal in T2WI did not correspond with the intervertebral disc level in 4 cases. For 10 cases the high signal in T2WI was found at two discontinuous segments. For 2 cases the 1 high signal in T2WI was found at over two segments. For 6 cases the high signal in T2WI was found at over three segments. Conclusions Disc hemiation is the most common underlyding factor in cervical hyperextension injury. The spinal level with high signal in T2WI was correlative to the impacted facial site. The shear force at the inflection point with or without the anterior-posterior compression force accounted for the cervical hyperextension injury. Key words: Cervical spine; Degeneration; Hyperextension injury; Segment distribution of injury; Vertebral dynamic change

Clinical research of delayed hyperextension injury concomitance spinal cord injury of cervical spine

To discuss Clinic feature and turnover of delayed hyperextension injury concomitance spinal cord injury of cervical spine. The clinic data of 30 patients delayed hyperextension injury of cervical spine were reviewed and analyzed. Course of disease was from 3 months to 8 years. Thirty patients were divided into three groups according to course of disease. The first group, 3 - 6 months, 17 cases; the second group, 6 - 12 months, 8 cases; the third group, 12 months-8 years, 5 cases. Neurological function improvement rates were evaluated according to the JOA scores at preoperative, 3 months and 1 year post operation, and complications were observed in three groups. Twenty-six cases were treated with anterior decompression, bone graft and plate fixation. Four cases were treated with posterior decompression, bone graft and plate fixation. The patient number of the three group exist with statistical significance. Thirty patients were followed up for 18 - 39 months, 23 months on average. Neurological function recovery rates were 23.8% in the first group, 53.9% in the second group and 54.3% in the third group at 1 year post operation. JOA scores of the first group and the second group with statistical significance at 3 months and 1 year post operation. JOA scores of the first group and the third group with statistical significance at 3 months and 1 year post operation. JOA scores of the second group and the third group without statistical significance at 3 months and 1 year post operation. Incidence of hyperextension injury associated with spinal cord injury of cervical spine would degrade along with course of disease prolong. If delayed spinal cord injury occurred earlier, the patient's condition was severer and badly improvement rate.

Exploration of approach in surgery for cervical hyperextension injury

To explore the reasonable approach in surgery for cervical hyperextension injury. Sixty-seven patients of hyperextension injury of cervical spine, 31 males and 16 females, aged 41 approximately 57, underwent surgery via anterior approach (n = 25), posterior approach (n = 27), or combined approach (n = 13) according to the different operation methods 8 days (3 days approximately 3 weeks) after the injury and then followed up for 6 approximately 12 months. The therapeutic effects were compared. After the operation, the Frankel grade was ascended in all patients of the anterior approach group, and was descended in some patients in the posterior approach and combined approach groups. The ASIA grade of the anterior approach and combined approach groups were both ascended in comparison with that of the posterior approach group (both P < 0.05) however, there was not significant difference between the anterior approach and combined approach groups. Anterior decompression-graft-internal fixation is the preferred consideration to treat hyperextension injury of cervical spine, and posterior one is only the secondary choice. Combined approach should be strictly selected according to the concrete situation.