Long term evaluation of result of surgically treated lower cervical spine trauma of 83 patients: A retrospective study

Objective: Retrospective evaluation of 83 patients who were surgically treated for lower cervical spine trauma. Materials and Methods: We retrospectively evaluated the 83 patients who operated because of lower cervical spine trauma in Ankara Training and Research Hospital Neurosurgery Clinic. All patients demographic data, type of trauma, cause of trauma, time of surgery, preoperative and postoperative neurologic grades were carefully evaluated. Only those who were closely followed up at least for 1 year, were included in the evaluation. The impact of surgical treatment on neurological status was assessed by using Frankel scale. Neurological improvement was assessed as mild, moderate and significant in respect to upgrade in Frankel scale in one step, two step and three or four step, respectively. Results: The number of male patients was 61 (73.5%) and the number of female patients was 22 (26.5%) The mean age was 45.1(±2,4). 49 patients had the other system injuries at the time of trauma. The most common cause of trauma was traffic accident (62,6%) and the most common mechanism was flexion injury (59%). The most common type of injury was dislocation (74,7%) and the C5 was the most frequently affected vertebra due to the trauma. 48 patients had various neurologic deficits at the time of admission (57,8%). Of these 48 patients 33 patients were surgically treated within the first 24 hours (68,75%) whereas 15 patients operated 24 hours later (31,25%). A total of 10 patients showed neurological improvement (12,04%). Although mild and moderate neurologic improvements were seen in patients who received early (<24 hours) or late (>24 hours) surgery, significant improvement was observed in patients who received surgery within 24 hours. The surgical approaches were anterior, posterior and combined in 73, 6 and 4 patients, respectively. Conclusion: Our study results indicate that the early surgical decompression and stabilization should be performed as soon as possible in patients with incomplete spinal cord injury. We also concluded that only anterior approach is an effective method in most patients who have cervical spinal trauma.