gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Results of surgery for subaxial fractures of the cervical spine

Ergebnisse der operativen Therapie bei subaxialen HWS-Frakturen

Meeting Abstract

Suche in Medline nach

  • corresponding author J. Klasen - Neurochirurgische Universitätsklinik Ulm im BKH Günzburg
  • H.-P. Richter - Neurochirurgische Universitätsklinik Ulm im BKH Günzburg
  • W. Börm - Neurochirurgische Universitätsklinik Ulm im BKH Günzburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP090

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0358.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Klasen et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Subaxial fractures of the cervical spine are severe injuries often combined with substantial neurological deficits. Surgical therapy aiming at decompression, realignment and stabilization can be achieved via the anterior, posterior or combined approach, and is accepted as standard at least for the unstable cervical spine.

With this study we report the surgical results in 82 consecutive patients treated in our institution.

Methods

Data were obtained retrospectively by reviewing patient charts and image studies. A standardised questionnaire was sent to all patients who could not be followed sufficiently on an ambulatory basis. Between January 1993 and December 2003, 82 patients (68 men and 14 women, mean age 45,8 years) with subaxial cervical fractures underwent 96 operations (51 via ventral approach, 26 dorsal and 19 combined). Fractures were divided according to the Magerl classification, neurological assessment was performed using the Frankel grading pre- and postoperatively. Patient satisfaction was evaluated and graded using a standardised 4-point scale. Mean follow-up was 37,9 months.

Results

Traffic accidents were the most frequent cause of injury in 42 cases. 59 (72%) patients sustained an isolated subaxial cervical fracture, 23 patients (28%) had additional injuries. Predominating type of fracture was Type B according to Magerl. 61 patients (74,4%) suffered from neurological deficits after the trauma, in 16 cases severe (Frankel Grade A and B), in 45 cases less severe (Frankel Grade C and D). 24 (39,3%) of them improved 1 or more grades on the Frankel Scale, 6 (9,8%) deteriorated 1 or more grades. Patients with severe neurological deficit usually did not improve after the operation. 5 (6,1%) patients died shortly after the trauma, 10 suffered other complications. In 31 cases we got information about the employment before and afterwards, 21 patients (67,7%) returned to their previous jobs, 10 (32,3%) could not. 53 (89,8%) patients of 59, who made a judgement, were satisfied or highly satisfied with the result of treatment.

Conclusions

Surgical decompression and stabilization of subaxial cervical fractures is an effective treatment option to prevent additional neurological impairment or improve existing neurological deficits. In cases of severe deficit recovery is worse. Even in these cases surgical stabilization facilitates rehabilitation.