Surgical treatment of patients with cervical spinal cord injury by anterior approach using bone graft

SURGICAL TREATMENT OF PATIENTS WITH CERVICAL SPINAL CORD INJURY BY ANTERIOR APPROACH USING BONE GRAFT (ABSTRACT)^*. THESIS. CAMPINAS, 2001.

MANOEL BALDOINO LEAL FILHO^**

The author reports an experience with 39 patients with acute cervical spine fractures and/or dislocations between C3 and C7. The average age was 41 and varied from 11 to 70 years old. Fall down was the most frequent cause of accident, the principal level was C5 and 79,5% of the patients arrived after eight hours of the trauma.

All of the patients were submitted to anterior approach using bone graft fixation without screw and plate systems and only three patients underwent posterior approach associated. Graft dislodgement occurred at a rate of 7.7% in post-operative time and 2.8% at one month because of technical problems with the vertebral endplate that was not drilled enough to receive and fix the graft. No redislodgement occurred.

All fusions became solid after three months, and all spinal columns were stable and painless after six months follow-up. Death occurred in three patients in post-operative time, neither one associated with surgical problems. Their progress based on the Frankel scale before surgery was A.51.3%, B 2.6%, C 15.4%, D 17.9%, E 12.8%, at the moment of the discharge was A 36.1%, B 8.3%, C 16.7%, D 16.7%, E 22.2% and with six months was A 22.2%, B 22.2%, C 11.1%, D 11.1%, E 33.4%.

The present experience shows how patients with acute cervical injury can improve even when the patients were admitted lately after trauma, were operated after the first week, with a bone graft anterior fixation and using a collar for three months till consolidation and had not received metilprednisolone.

KEY WORDS: cervical spine, spinal injury, anterior fusion, spinal fusion.

**Address: Rua 7 de setembro 526 ¾ sul, 64001-210 Teresina PI, Brasil. E-mail: [e-mail]

*

Tratamento cirúrgico de pacientes com traumatismo raquimedular cervical pela via anterior utilizando enxerto ósseo (Resumo). Tese de Mestrado, Universidade Estadual de Campinas, UNICAMP (Área: Ciências Médicas). Orientador: Guilherme Borges.

Publication Dates

• Publication in this collection
  11 Apr 2002
• Date of issue
  Mar 2002