Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture Dislocation
Objective The incidence of severe lower cervical fractures and dislocations due to trauma has increased significantly, and the optimal treatment remains controversial. This study compares the safety and efficacy of anterior cervical discectomy fusion (ACDF) combined with lateral mass screw (LMS) and...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13868 |
| _version_ | 1797666349916356608 |
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| author | Yingchuang Tang Hanwen Li Shangwu Zhang Hao Liu Junxin Zhang Huilin Yang Kai Zhang Genlin Wang Kangwu Chen |
| author_facet | Yingchuang Tang Hanwen Li Shangwu Zhang Hao Liu Junxin Zhang Huilin Yang Kai Zhang Genlin Wang Kangwu Chen |
| author_sort | Yingchuang Tang |
| collection | DOAJ |
| description | Objective The incidence of severe lower cervical fractures and dislocations due to trauma has increased significantly, and the optimal treatment remains controversial. This study compares the safety and efficacy of anterior cervical discectomy fusion (ACDF) combined with lateral mass screw (LMS) and with cervical pedicle screw (CPS) fixation surgery under O‐arm navigation as single‐stage treatments of severe lower cervical fracture dislocations. Methods Data from 48 patients who underwent ACDF + CPS (Group A) or ACDF + LMS (Group B) for severe lower cervical fracture dislocation between January 2016 and September 2020 were retrospectively reviewed. Groups A and B comprised 25 and 23 cases, respectively. Clinical parameters, such as operative time, intraoperative blood loss, number of fixed segments, posterior incision length, operative complications, and hospitalization days were recorded. Preoperatively and postoperatively, the sub‐axial injury classification (SLIC) score, the American Spinal Injury Association (ASIA) impairment scale, and the Japanese Orthopaedic Association (JOA) score were recorded and analyzed using Student's t‐test. Results The SLIC scores were 7.1 ± 1.2 and 7.5 ± 1.1, ASIA were 1.5 ± 0.6 and 1.2 ± 0.6, JOA score improvements were 3.2 ± 2.4 and 3.0 ± 2.1, operative times were 282.1 ± 91.7 and 266.5 ± 88.2 min, intraoperative blood losses were 437.8 ± 118.5 and 418.7 ± 104.2 mL, fixed segments were 2.8 ± 0.7 and 4.8 ± 1.1, and lengths of posterior incisions were 12.7 ± 2.8 and 13.8 ± 3.2 cm in Groups A and B, respectively. There was no significant difference between the two groups in the operative time, intraoperative blood loss, incision length, and postoperative recovery; however, group A had more fixed segments. At the final follow‐up, no intraoperative or postoperative complications directly caused by the implant were present. Throughout the follow‐up, all cases showed recovery and progressive improvement. Conclusion Both ACDF + LMS and ACDF + CPS under O‐arm navigation can safely and effectively restore cervical vertebral sequence, fully release spinal canal compression, and promote patients’ neurological recovery. Thus, both are effective treatments for severe lower cervical fracture dislocations. However, compared to LMS, CPS under O‐arm navigation has shorter fixed segments and induces less trauma. |
| first_indexed | 2024-03-11T19:58:21Z |
| format | Article |
| id | doaj.art-3dd21b28602e496ca2292c10db0cb349 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-03-11T19:58:21Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-3dd21b28602e496ca2292c10db0cb3492023-10-04T14:23:12ZengWileyOrthopaedic Surgery1757-78531757-78612023-10-0115102647265510.1111/os.13868Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture DislocationYingchuang Tang0Hanwen Li1Shangwu Zhang2Hao Liu3Junxin Zhang4Huilin Yang5Kai Zhang6Genlin Wang7Kangwu Chen8Department of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Emergency Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaDepartment of Orthopaedic Surgery The First Affiliated Hospital of Soochow University Suzhou ChinaObjective The incidence of severe lower cervical fractures and dislocations due to trauma has increased significantly, and the optimal treatment remains controversial. This study compares the safety and efficacy of anterior cervical discectomy fusion (ACDF) combined with lateral mass screw (LMS) and with cervical pedicle screw (CPS) fixation surgery under O‐arm navigation as single‐stage treatments of severe lower cervical fracture dislocations. Methods Data from 48 patients who underwent ACDF + CPS (Group A) or ACDF + LMS (Group B) for severe lower cervical fracture dislocation between January 2016 and September 2020 were retrospectively reviewed. Groups A and B comprised 25 and 23 cases, respectively. Clinical parameters, such as operative time, intraoperative blood loss, number of fixed segments, posterior incision length, operative complications, and hospitalization days were recorded. Preoperatively and postoperatively, the sub‐axial injury classification (SLIC) score, the American Spinal Injury Association (ASIA) impairment scale, and the Japanese Orthopaedic Association (JOA) score were recorded and analyzed using Student's t‐test. Results The SLIC scores were 7.1 ± 1.2 and 7.5 ± 1.1, ASIA were 1.5 ± 0.6 and 1.2 ± 0.6, JOA score improvements were 3.2 ± 2.4 and 3.0 ± 2.1, operative times were 282.1 ± 91.7 and 266.5 ± 88.2 min, intraoperative blood losses were 437.8 ± 118.5 and 418.7 ± 104.2 mL, fixed segments were 2.8 ± 0.7 and 4.8 ± 1.1, and lengths of posterior incisions were 12.7 ± 2.8 and 13.8 ± 3.2 cm in Groups A and B, respectively. There was no significant difference between the two groups in the operative time, intraoperative blood loss, incision length, and postoperative recovery; however, group A had more fixed segments. At the final follow‐up, no intraoperative or postoperative complications directly caused by the implant were present. Throughout the follow‐up, all cases showed recovery and progressive improvement. Conclusion Both ACDF + LMS and ACDF + CPS under O‐arm navigation can safely and effectively restore cervical vertebral sequence, fully release spinal canal compression, and promote patients’ neurological recovery. Thus, both are effective treatments for severe lower cervical fracture dislocations. However, compared to LMS, CPS under O‐arm navigation has shorter fixed segments and induces less trauma.https://doi.org/10.1111/os.13868Anterior Cervical Discectomy FusionCervical Pedicle ScrewConventional Lateral Mass ScrewSevere Lower Cervical Fracture Dislocations |
| spellingShingle | Yingchuang Tang Hanwen Li Shangwu Zhang Hao Liu Junxin Zhang Huilin Yang Kai Zhang Genlin Wang Kangwu Chen Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture Dislocation Orthopaedic Surgery Anterior Cervical Discectomy Fusion Cervical Pedicle Screw Conventional Lateral Mass Screw Severe Lower Cervical Fracture Dislocations |
| title | Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture Dislocation |
| title_full | Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture Dislocation |
| title_fullStr | Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture Dislocation |
| title_full_unstemmed | Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture Dislocation |
| title_short | Comparison of Anterior Cervical Discectomy Fusion Combined with Lateral Mass Screw and with Cervical Pedicle Screw Fixation Surgery under O‐Arm Navigation for Single‐Stage Management of Severe Lower Cervical Fracture Dislocation |
| title_sort | comparison of anterior cervical discectomy fusion combined with lateral mass screw and with cervical pedicle screw fixation surgery under o arm navigation for single stage management of severe lower cervical fracture dislocation |
| topic | Anterior Cervical Discectomy Fusion Cervical Pedicle Screw Conventional Lateral Mass Screw Severe Lower Cervical Fracture Dislocations |
| url | https://doi.org/10.1111/os.13868 |
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