Debate exists in the literature about the surgical management of sub-axial cervical burst fractures regarding the approach and types of fixation of these injuries. Our Acute Spinal Injury (ASCI) unit prefers anterior only cervical corpectomy and plate fixation in the management of these injuries. The objective of this study was to radiologically assess the long term outcomes (minimum 2 yrs) of our series. Patients were identified using the Acute Spinal Injury Unit (ASCI) database that had had anterior only corpectomy and plate fixation for trauma as a standardised procedure between 2006 and 2009. Initial post-op radiological review included the sagittal alignment, hardware characteristics and surgical technique. Radiological review after a minimum of 24 months involved the union, sagittal alignment, hardware characteristics, graft incorporation and adjacent level degeneration at the site of injury.Purpose of Study
Patients and Methods
Cervical bifacet dislocations are devastating injuries and require early reduction and surgical stabilization. Closed reduction is safe and neurological deterioration is rare. Pre-reduction MRI can cause clinical uncertainty as to the safety of closed reduction when a significant sequestrated disc is found. This study explores the direct cord pressures in a bifacet dislocation model with the use of fresh frozen cadaver cervical spines and a Tekscan Pressure Measurement System. Surgical dislocations were created and pressure monitors inserted into the canal. Pressures on the cord from the posterior-superior edge of the caudal body as well as that from the cranial body were assessed at the level of the dislocation. The effects of the presence of a disc and its size, reduction angles and level of dislocation before and during closed reduction were evaluated. The average dislocated spinal cord pressures were measured at 3.81 kPa and increased to 20.22 kPa under traction. This decreased to 1.295 kPa after cervical spine reduction. Average cord pressures as well as peak loading pressures were shown to increase with the increasing size of the prolapsed disc and diminished once the spine was reduced.Method
Results
