Outcome Of Traumatic Cervical Spine Facet Subluxation Using Pre-Filled Cervical Cage And Anterior Cervical Plating

Abstract

Backgrounds: This study assesses the efficacy of anterior cervical decompression and fusion utilizing a pre-filled cage, coupled with anterior cervical plating for traumatic facet joint subluxation. Key considerations include neurological outcomes, post-operative cervical spine stability, and immediate rehabilitation.

Patient & Methods: This study was conducted at Erbil Teaching Hospital and PAKY Hospital from July 2014 to March 2021. It included a total of 128 individuals diagnosed with cervical facet dislocations. Every patient had comprehensive clinical and imaging assessments. The ASIA impairment scale was used to first evaluate neurological deficits. Every participant received cervical traction. An extensive set of pre-and post-operative data was gathered, which included X-rays and MRI scans. Individuals with facet dislocations from C3 to C7 had decompression and fusion procedures employing an anterior approach, which included the use of a pre-filled cervical cage and a titanium plate system.

 Results: The study sample comprised 110 males (85%) and 18 females (15%), aged between 18 and 60 years. Complete spinal cord injuries were observed in 14 cases (10.9%), while 114 cases (89%) exhibited partial cord injuries. The most common causes of trauma were falls from heights and motorcycle accidents. Post-surgical assessments indicated significant improvements in clinical and radiographic outcomes. The use of a pre-filled cervical cage facilitated early rehabilitation: 34.46% of patients improved by one ASIA grade, 42.94% by two grades, and 22.6% transitioned from wheelchair dependence. The only noted post-operative complication was transient dysphagia.

Conclusion:Anterior cervical decompression and fusion employing a pre-filled cage and anterior plating with a titanium system have demonstrated high effectiveness, yielding excellent neurological improvements and successful fusion rates, as confirmed by radiological assessments.