Abstract
Of 101 patients with acute injury to the cervical spine below the level of the axis, 74 were selected for anterior operation to ensure stability and comfort and to decompress the neural elements when indicated. Forty-six of the patients underwent a Cloward fusion at the level of the injury. Twenty-eight were treated by bar graft fusion. The indications for these procedures and the techniques involved are outlined. A successful operative result was achieved primarily in 65 of the 74 patients and eventually in 73 patients. The management mortality for patients treated by anterior operation was 27 per cent. The advantages of these procedures are the achievement of comfort, the facilitation of early rehabilitation, the maintenance of bony alignment and the preservation and maximal recovery of neurological function.
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Beatson, T S (1963). Fractures and dislocations of the cervical spine. J. Bone Joint Surg. 45B, 21–35.
Botterell, E H, Jousse, A T, Kraus, A S, Thompson, M G, Wynne-Jones, M & Geisler, W O (1975). A model for the future care of acute spinal cord injuries. Ann. R. Coll. Phys. Surg. Canada, 8, 193–218.
Braakman, R & Penning, L (1973). Mechanisms of injury to the cervical cord. Paraplegia, 10, 314–320.
Burke, D C & Berryman, D (1971). The place of closed manipulation in the management of flexion-rotation dislocations of the cervical spine. J. Bone Joint Surg. 53B, 165–182.
Cheshire, D J E (1970). The stability of the cervical spine following the conservative treatment of fractures and fracture-dislocations. Paraplegia, 7, 193–203.
Clawson, D K et al. (1971). Early anterior fusion for cervical spine injury. J.A.M.A. 215, 2113–2114 (letter to Editor).
Cloward, R B (1961). Treatment of acute fractures and fracture-dislocations of the cervical spine by vertebral body fusion. J. Neurosurg. 18, 201–209.
Drake, C G (1962). Cervical spinal cord injury. J. Neurosurg. 19, 487–494.
Evans, D K (1961). Reduction of cervical dislocation. J. Bone Joint Surg. 43B, 552–555.
Guttmann, L (1965). Initial treatment of traumatic paraplegia and tetraplegia. In Spinal Injuries Symposium, Morrison and Gibb Ltd., Edinburgh.
Guttmann, L (1976). Spinal Cord Injuries and Comprehensive Management and Research. Blackwell, Oxford, 2nd edition.
Hardy, A G (1976). Survival periods in traumatic tetraplegia. Paraplegia, 14, 41–46.
Holdsworth, F W (1963). Fractures, dislocations and fracture-dislocations of the spine. J. Bone Joint Surg. 45B, 6–20.
Jacobs, B (1975). Cervical fractures and dislocations, C3-7. Clin. Orthopaedics and Related Research, 109, 18–32.
Kessler, L A (1973). Delayed traumatic dislocation of the cervical spine. J.A.M.A. 224, 124–125.
Nieminen, R (1973). Fractures of spinous processes of the lower cervical spine. Ann. Chir, Gynaecol. Fenn, 62, 328–333.
Nieminen, R (1974). Fractures of the articular processes of the lower cervical spine. Ann. Chir, Gynaecol. Fenn, 63, 204–211.
Norrell, H & Wilson, C B (1970). Early anterior fusion for injuries of the cervical portion of the spine. J.A.M.A. 214, 525–530.
Ransohoff, J R & Sadik, A R (1972). Spinal cord injury: current status and recent advances. Surg. Ann. 4, 91–101.
Raynor, R B (1968). Severe injuries of the cervical spine treated by early anterior interbody fusion and ambulation. J. Neurosurg. 20, 311–316.
Rogers, W A (1957). Fractures and dislocations of the cervical spine. J. Bone Joint Surg. 39A, 341–376.
Schneider, R C (1957). Cervical traction, with evaluation of methods and treatment of complications. Surg. Gyn. and Obst. 104, 521–530.
Stauffer, E S & Kaufer, H (1975). Fractures and dislocations of the spine. In Fractures (Vol. 2), ed. by C. A. Rockwood and D. P. Green. Lippincott, Philadelphia.
Verbiest, H (1973). Anterolateral operations for fractures or dislocations of the cervical spine due to injuries or previous surgical interventions. Clin. Neurosurg. 20, 334–366.
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Horsey, W., Tucker, W., Hudson, A. et al. Experience with early anterior operation in acute injuries of the cervical spine. Spinal Cord 15, 110–122 (1977). https://doi.org/10.1038/sc.1977.16
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DOI: https://doi.org/10.1038/sc.1977.16