Anterior reduction and fusion for acute unilateral cervical facet dislocation without severe spinal cord injuries

Abstract

Purpose: This study aimed to evaluate safety and effectiveness of simple anterior reduction and fusion for acute lower cervical unilateral facet dislocation without severe spinal cord injuries.

Materials and methods: One hundred and two patients with unilateral cervical facet dislocations without severe spinal cord injuries who were surgically treated by the only anterior approach were analyzed. The treatment effects were evaluated based on the Visual Analogue Scale (VAS) scores, the Cobb angle of kyphosis, the Neck Disability Index (NDI) and Odom's criteria. Neurological recovery of patients was assessed by the Frankel grading.

Results: The mean duration of follow-up was 12.4 ± 4.2 years (range, 10 to 17 years). VAS scores, Kyphosis angle and NDI scores were significantly changed from preoperative values of 7.4 ± 0.8, 11.3° ± 6.8° and 29.3 ± 5.1 to last follow-up values of 1.3 ± 0.8, -6.1° ± 7.5° and 8.8 ± 3.6 (P = 0.000). Of patients, 92 (90.2%) had good to excellent outcomes, 9 (8.8%) had satisfactory outcomes, and 1 (1.0%) had poor outcomes. Patients have obtained satisfactory neurological recovery. Three patients needed additional posterior reduction.

Conclusion: The anterior reduction and fusion is effective and safe for acute unilateral cervical facet dislocation, and can achieve good long-term clinical effects.

Keywords: Anterior reduction; Cervical facet dislocations; Unilateral.