Role of Anterior Cervical Decompression Fusion and Plating in Lower Cervical Spine Caries

Abstract

Cervical spine injury is one of the leading causes of spinal cord injury in the year 2013. In 2013, a total of 43.9% of cases of cervical spine injury was reported worldwide. The incidence of cervical spine injuries occurred due to accidents that happened in prime age. The major goal of this research was to explore the role of anterior cervical decompression fusion and plating in lower cervical spine caries. Methodology: This prospective study was conducted in Sheikh zayed hospital rahim yar Khan in duration of January 2017 to December 2019, a total of 365 patients were presented in the emergency department of Sheikh zayed hospital rahim yar khan for the subaxial cervical spine surgery. All these patients were analyzed and only 21 patients matched the inclusion criteria of our study. The neurological condition of patients was accessed through American Spinal Injury Association (ASIA) impairment scale (AIS). All the patients underwent through radiological assessment. With the help of an X-ray on the cervical spine, we measured parameters including local segmental angle formed between two lines, Ishihara curvature index, the step of distance, and angle of cervical lordosis.
Results: Association of disc herniation was reported in six patients. Among these of six one was reported with injury level at C3-4, in 2 cases level was C4-5 and C5-6 reported in 3 patients. In one case longer plate fixation, C4-7 was performed due to injury at C4-5 level associated with C6 fracture. We observed 16.3% as the mean value of the NDI score We did not find any significant correlation of NDI with kyphotic angle.
Conclusion: Our study concluded that anterior reduction decompression and fusion with plating is an effective method to manage subaxial cervical trauma injuries. The fusion state and patient feedback were highly satisfactory and considered as one of the successful positive outcomes of the anterior decompression method. Anterior decompression takes less time as compared to the posterior approach. However, this method failed to achieve the full reduction and the injured segment did not return to its normal lordosis.