Analysis on efficacy of anterior surgery on irreducible dislocation of the lower cervical spine

Objective: To explore the reduction,security,reliability and efficacy of anterior surgery on irreducible dislocation of the lower cervical spine.Methods: Fourteen cases of the lower cervical dislocation that could not be reduced by the skull traction received anterior surgery;nine cases of unilateral dislocation of the upper and lower vertebrae were distracted and rotated to untie the interlocking and then reduced;five cases of bilateral dislocation of the upper and lower vertebrae were distracted and depressed the upper vertebral body and pried the lower one to untie the interlocking and reduced,and then bone graft was performed and a steel plate was used for fixation.Results: The follow-up lasted from to 48 months.One case of C₄ dislocation with paraplegia died one week after the operation because of respiratory muscle paralysis.The other 13 cases were evaluated according to ASIA Classification Standard:4 cases which had no response to the therapy were classified as grade A,4 cases were classified as grade B,of which 2 cases improved and were elevated to grade C,3 cases were rated as grade C and then improved to grade D,and 2 cases were rated as grade D and then improved to grade E.Conclusions: The anterior surgery can untie the interlocking and reach reduction at one stage,which may avoid complicated operations such as associated approach of anterior and posterior surgery or traditional surgery with the skull traction,thus reducing surgical trauma and risk.