Outcome in Lower Cervical Spine Injuries (Treated Surgically)

Abstract

Fracture dislocation of the cervical spine is amongst the most serious injuries that can result from fall, industrial accident, automobile accidents and athletic activities. They cause a broad spectrum of disabling conditions ranging from minor pains to quadriplegia and even death. Cervical spine injuries are usually treated by skeletal traction for 3-6 weeks. By this method proper decompression, bony fusion and stabilization of the injured cervical spine is not possible. It also results in many complications i.e. bed sores, infection etc. Surgical management of the cervical spine injuries provides proper decompression, and enhances bony fusion & stabilization of the spine thus allowing early mobilization of the patient. With early mobilization the complications are tremendously reduced. It also reduces the hospital stay of the patient and offers ideal circumstances for recovering the neurological deficit. A study was conducted in the department of Neurosurgery Lahore General Hospital, Lahore comprising of 20 consecutive patients of lower cervical spine injuries which were treated surgically. Excluding the three patients who were in Grade E (Frankel grading), 75% of patients improved as regard of their grading. At the end of follow up of 6 months, only 20% of patients were in the non useful grades i.e. A, B & C. There were no complications like bed sore, thromboembolic phenomena, UTI and nonunion of the spine producing chronic instability. It was concluded that patients of lower cervical spine injuries treated surgically with early mobilization results in dramatic improvement in outcome with negligible rate of complications.