Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations
Objective. To identify factors leading to the loss of correction and redislocation of the vertebrae after isolated anterior reconstruction and stabilization in the surgical treatment of subaxial cervical dislocations. Material and Methods. A retrospective cohort STROBE-type study was carried out...
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| Format: | Article |
| Language: | English |
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Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2020-09-01
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| Series: | Хирургия позвоночника |
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| Online Access: | https://www.spinesurgery.ru/jour/article/view/1722/1716 |
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| author | Alexey D. Lastevsky Vitaliy L. Lukinov Viktor V. Rerikh |
| author_facet | Alexey D. Lastevsky Vitaliy L. Lukinov Viktor V. Rerikh |
| author_sort | Alexey D. Lastevsky |
| collection | DOAJ |
| description | Objective. To identify factors leading to the loss of correction and redislocation of the vertebrae after isolated anterior reconstruction and
stabilization in the surgical treatment of subaxial cervical dislocations.
Material and Methods. A retrospective cohort STROBE-type study was carried out using data of 175 patients with dislocations of vertebrae in the subaxial cervical spine who were operated on in 2010–2019. The key parameters of the study were the relevant indices of the cervical sagittal balance and morphological characteristics of the injury: thoracic inlet angle (TIA), T1 vertebra slope, neck tilt, regional cervical C2–C7 lordosis, fracture of the vertebral body, and fracture of the articular process at the level of dislocation. Statistical analysis of the obtained data was carried out in the RStudio program.
Results. At preoperative TIA value of 74.5°, the risk of correction loss corresponds to 28 %. In the group with TIA < 74.5° and that with TIA ≥ 74.5°, the risk of correction loss is 17.3 % (95 % CI: 7–37 %) and 85.7 % (95 % CI: 60–96 %), respectively. With an increase in TIA by 10°, the chance of recurrence increases by 23.3 times. The effect of the articular process fracture on the loss of correction is equivalent to an increase in TIA by 10°, namely, it increases the chance of recurrence by 20.7 times. The parameter “duration of injury” has an effect on the loss of correction, but it is statistically insignificant (p > 0.05).
Conclusion. The parameter of the cervical sagittal balance, thoracic inlet angle, as well as the fracture of the articular process at the level of injury are statistically significant factors that determine the initial stability in isolated anterior surgical reconstruction and stabilization of the lower cervical spine for Allen type 3 flexion-distraction injuries. |
| first_indexed | 2024-03-12T09:36:36Z |
| format | Article |
| id | doaj.art-f3be3c5a4cb74390aaa5060a2f1ed88f |
| institution | Directory Open Access Journal |
| issn | 1810-8997 2313-1497 |
| language | English |
| last_indexed | 2024-03-12T09:36:36Z |
| publishDate | 2020-09-01 |
| publisher | Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" |
| record_format | Article |
| series | Хирургия позвоночника |
| spelling | doaj.art-f3be3c5a4cb74390aaa5060a2f1ed88f2023-09-02T13:38:09ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972020-09-01173203110.14531/ss2020.3.20-31Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocationsAlexey D. Lastevsky0https://orcid.org/0000-0001-5917-1910Vitaliy L. Lukinov1https://orcid.org/0000-0002-3411-508XViktor V. Rerikh2https://orcid.org/0000-0001-8545-0024Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, RussiaInstitute of Computational Mathematics and Mathematical Geophysics SB RAS, Novosibirsk, RussiaNovosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, RussiaObjective. To identify factors leading to the loss of correction and redislocation of the vertebrae after isolated anterior reconstruction and stabilization in the surgical treatment of subaxial cervical dislocations. Material and Methods. A retrospective cohort STROBE-type study was carried out using data of 175 patients with dislocations of vertebrae in the subaxial cervical spine who were operated on in 2010–2019. The key parameters of the study were the relevant indices of the cervical sagittal balance and morphological characteristics of the injury: thoracic inlet angle (TIA), T1 vertebra slope, neck tilt, regional cervical C2–C7 lordosis, fracture of the vertebral body, and fracture of the articular process at the level of dislocation. Statistical analysis of the obtained data was carried out in the RStudio program. Results. At preoperative TIA value of 74.5°, the risk of correction loss corresponds to 28 %. In the group with TIA < 74.5° and that with TIA ≥ 74.5°, the risk of correction loss is 17.3 % (95 % CI: 7–37 %) and 85.7 % (95 % CI: 60–96 %), respectively. With an increase in TIA by 10°, the chance of recurrence increases by 23.3 times. The effect of the articular process fracture on the loss of correction is equivalent to an increase in TIA by 10°, namely, it increases the chance of recurrence by 20.7 times. The parameter “duration of injury” has an effect on the loss of correction, but it is statistically insignificant (p > 0.05). Conclusion. The parameter of the cervical sagittal balance, thoracic inlet angle, as well as the fracture of the articular process at the level of injury are statistically significant factors that determine the initial stability in isolated anterior surgical reconstruction and stabilization of the lower cervical spine for Allen type 3 flexion-distraction injuries.https://www.spinesurgery.ru/jour/article/view/1722/1716anterior cervical discectomy and stabilizationanterior spinal fusioncervical sagittal balancedislocations of cervical verte- braerecurrent dislocationre-dislocationloss of correctionflexion-distraction injury |
| spellingShingle | Alexey D. Lastevsky Vitaliy L. Lukinov Viktor V. Rerikh Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations Хирургия позвоночника anterior cervical discectomy and stabilization anterior spinal fusion cervical sagittal balance dislocations of cervical verte- brae recurrent dislocation re-dislocation loss of correction flexion-distraction injury |
| title | Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations |
| title_full | Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations |
| title_fullStr | Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations |
| title_full_unstemmed | Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations |
| title_short | Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations |
| title_sort | predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations |
| topic | anterior cervical discectomy and stabilization anterior spinal fusion cervical sagittal balance dislocations of cervical verte- brae recurrent dislocation re-dislocation loss of correction flexion-distraction injury |
| url | https://www.spinesurgery.ru/jour/article/view/1722/1716 |
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