A prospective study of subaxial spine injuries: An armed forces experience
Introduction: Cervical spine injuries account for 3% of all polytrauma patients and can lead to quadriplegia, significant functional loss, and permanent disability. A large spectrum of such cases requires surgical decompression and reconstruction with variable neurological outcomes. Aims and Objecti...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Medical Journal of Dr. D.Y. Patil Vidyapeeth |
| Subjects: | |
| Online Access: | http://www.mjdrdypv.org/article.asp?issn=2589-8302;year=2020;volume=13;issue=4;spage=368;epage=372;aulast=Maheshwari |
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| author | Vikas Maheshwari Maneet Gill Aishik Mukherjee Rushikesh Gadhavi |
| author_facet | Vikas Maheshwari Maneet Gill Aishik Mukherjee Rushikesh Gadhavi |
| author_sort | Vikas Maheshwari |
| collection | DOAJ |
| description | Introduction: Cervical spine injuries account for 3% of all polytrauma patients and can lead to quadriplegia, significant functional loss, and permanent disability. A large spectrum of such cases requires surgical decompression and reconstruction with variable neurological outcomes. Aims and Objectives: The aim of the study was to critically review the subaxial cervical spine injury cases managed surgically with different types of implants at a tertiary level armed forces hospital and analyze their postoperative outcomes. Methods: A prospective analysis of patients (n = 85) of subaxial cervical spine injury was carried out between October 2014 and December 2017. The last patient of our study on July 17 was followed for 5 months. Surgical decompression and stabilization were done in 71 patients whereas 14 patients were managed conservatively. Pre- and post-operative neurological outcome was assessed by the American Spinal Injury Association (ASIA) score. Results: There were 81 men and 04 women whose mean age was 39 years (range 16–78 years). The most common cause of injury was road traffic accidents (45%, n = 38). C5-C6 was the most common site of injury 46% (n = 39). ASIA Grade C (n = 27, 32%) was the most common presentation. Seventy-one cases were treated surgically; 95% (n = 68) of through the anterior approach, 2 by the posterior approach and one by a combined approach. Of the 44 patients operated within 24 h of injury, 19 (43%) had a two-grade improvement in their ASIA scores, 5 (11%) had a one-grade improvement and the remaining 20 showed no change. Only one patient out of 27 patients operated 24 h after the injury showed improvement in ASIA grade. Conclusion: Subaxial cervical spine injuries are complex and a definite treatment algorithm is still a work in progress. However, early surgical decompression and stabilization lead to good neurological outcome in the majority of cases. |
| first_indexed | 2024-04-11T22:55:49Z |
| format | Article |
| id | doaj.art-d55cb053e4ae4893b5287b527ec5ce6f |
| institution | Directory Open Access Journal |
| issn | 2589-8302 2589-8310 |
| language | English |
| last_indexed | 2024-04-11T22:55:49Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Medical Journal of Dr. D.Y. Patil Vidyapeeth |
| spelling | doaj.art-d55cb053e4ae4893b5287b527ec5ce6f2022-12-22T03:58:27ZengWolters Kluwer Medknow PublicationsMedical Journal of Dr. D.Y. Patil Vidyapeeth2589-83022589-83102020-01-0113436837210.4103/mjdrdypu.mjdrdypu_221_19A prospective study of subaxial spine injuries: An armed forces experienceVikas MaheshwariManeet GillAishik MukherjeeRushikesh GadhaviIntroduction: Cervical spine injuries account for 3% of all polytrauma patients and can lead to quadriplegia, significant functional loss, and permanent disability. A large spectrum of such cases requires surgical decompression and reconstruction with variable neurological outcomes. Aims and Objectives: The aim of the study was to critically review the subaxial cervical spine injury cases managed surgically with different types of implants at a tertiary level armed forces hospital and analyze their postoperative outcomes. Methods: A prospective analysis of patients (n = 85) of subaxial cervical spine injury was carried out between October 2014 and December 2017. The last patient of our study on July 17 was followed for 5 months. Surgical decompression and stabilization were done in 71 patients whereas 14 patients were managed conservatively. Pre- and post-operative neurological outcome was assessed by the American Spinal Injury Association (ASIA) score. Results: There were 81 men and 04 women whose mean age was 39 years (range 16–78 years). The most common cause of injury was road traffic accidents (45%, n = 38). C5-C6 was the most common site of injury 46% (n = 39). ASIA Grade C (n = 27, 32%) was the most common presentation. Seventy-one cases were treated surgically; 95% (n = 68) of through the anterior approach, 2 by the posterior approach and one by a combined approach. Of the 44 patients operated within 24 h of injury, 19 (43%) had a two-grade improvement in their ASIA scores, 5 (11%) had a one-grade improvement and the remaining 20 showed no change. Only one patient out of 27 patients operated 24 h after the injury showed improvement in ASIA grade. Conclusion: Subaxial cervical spine injuries are complex and a definite treatment algorithm is still a work in progress. However, early surgical decompression and stabilization lead to good neurological outcome in the majority of cases.http://www.mjdrdypv.org/article.asp?issn=2589-8302;year=2020;volume=13;issue=4;spage=368;epage=372;aulast=Maheshwariamerican spinal injury association scoresubaxial cervical spinesubaxial injury classification system score |
| spellingShingle | Vikas Maheshwari Maneet Gill Aishik Mukherjee Rushikesh Gadhavi A prospective study of subaxial spine injuries: An armed forces experience Medical Journal of Dr. D.Y. Patil Vidyapeeth american spinal injury association score subaxial cervical spine subaxial injury classification system score |
| title | A prospective study of subaxial spine injuries: An armed forces experience |
| title_full | A prospective study of subaxial spine injuries: An armed forces experience |
| title_fullStr | A prospective study of subaxial spine injuries: An armed forces experience |
| title_full_unstemmed | A prospective study of subaxial spine injuries: An armed forces experience |
| title_short | A prospective study of subaxial spine injuries: An armed forces experience |
| title_sort | prospective study of subaxial spine injuries an armed forces experience |
| topic | american spinal injury association score subaxial cervical spine subaxial injury classification system score |
| url | http://www.mjdrdypv.org/article.asp?issn=2589-8302;year=2020;volume=13;issue=4;spage=368;epage=372;aulast=Maheshwari |
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