• J Spinal Disord Tech · May 2014

    Case Reports Clinical Trial

    A new anterior-posterior surgical approach for the treatment of cervical facet dislocations.

    • Biao Wang, Yue Zhu, Ying Jiao, Feng Wang, Xinchun Liu, Haitao Zhu, Guanjun Tu, and Deyong Liang.
    • Department of Orthopaedics, First Hospital, China Medical University, Shenyang, China.
    • J Spinal Disord Tech. 2014 May 1;27(3):E104-9.

    Study DesignThe preliminary results from a new anterior-posterior surgical approach are reported.ObjectiveTo report a novel surgical approach, which was successfully applied to treat 8 cervical facet dislocation patients.Summary Of Background DataThe combined anterior-posterior surgical procedure is used as a common approach in the treatment of cervical facet dislocations. However, some problems may arise during the application of this approach, and as a result, surgeons must change the initial surgical plan to anterior-posterior-anterior approach.MethodsBetween December 2011 and June 2012, 8 patients had facet dislocations were surgically treated by the new anterior-posterior approach. After anterior discectomy, a peek frame cage containing autologous iliac bone particles or tricalcium phosphate bone substitute was inserted in the interspace and fixed with a peek composite buttress plate screwed into the inferior vertebral body. Then, the anterior wound was closed and the patient was turned prone. Through a posterior midline approach, the posterior elements were exposed and the reduction was gradually achieved by posteriorly translating the superior segment and progressively positioning the patient's neck into extension. Then lateral mass or pedicle screws and titanium rods were placed in a favorable and satisfactory position, which was demonstrated by the intraoperative plain radiographs. A posterolateral fusion was performed and the posterior wound was closed.ResultsWith the use of this new approach, all the patients had obtained successful reduction and satisfactory anatomic sagittal alignment. No instances of neurological deterioration and instrument failure occurred, no complications were owing to the use of this technique, and 4 patients existed neurological functional recovery at the most recent follow-up visit.ConclusionsThis reported surgical approach is an efficient and safe way for the treatment of traumatic cervical facet dislocations.

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