Locking screw-plate fixation of cervical spine fractures with and without ancillary posterior plating.

摘要: Forty consecutive patients with 19 fractures and 21 fracture-dislocations in the lower cervical spine were treated prospectively open reduction interbody fusion, using AO titanium locking screw-plate system. There 30 men 10 women a mean age of 36 years (range 16-90 years). Eight admitted tetraplegic, 12 tetraparetic, 6 had nerve root injuries. Eleven 18 also plated posteriorly. Complications included two cardiac arrests, transient neurological impairments, severe gastrointestinal bleedings, one esophageal fistula. At 2-year follow-up, three died emigrated. Three out ten who complete motor loss initially regained useful muscle function, while incomplete usually returned to normal. All fusions healed good or acceptable position. Twenty-four 60 posterior plates impinged on facet joints five loose. Six screws transgressed below fusion. Ten extended adjacent mobile segments by exuberant bony overgrowth. Ancillary plating significantly reduced range neck mobility caused more pain than anterior plate fixation alone.