SA Orthopaedic Journal
On-line version ISSN 2309-8309
MCGUIRE, DT and KRUGER, N. Cervical corpectomy and anterior standalone plate stabilisation in sub-axial cervical spine trauma: a retrospective review of the radiological outcomes. SA orthop. j. [online]. 2010, vol.9, n.1, pp. 48-54. ISSN 2309-8309.
INTRODUCTION: Compression-flexion injuries of the cervical spine often result in instability of both the anterior and posterior columns. Debate exists in the literature regarding the surgical approach to stabilisation of these fractures, the options being anterior, posterior or combined surgical approaches. The combined approach offers superior stability, but results in increased cost, patient morbidity and theatre time. This study reviews the results of the anterior approach with standalone cervical corpectomy and plate stabilisation combined with postoperative Philadelphia collar immobilisation. METHODS: We retrospectively reviewed 30 patients with compression-flexion injuries of the cervical spine. Surgical management consisted of anterior corpectomy, iliac tricortical strut autograft, and anterior cervical static locked plating. Postoperatively patients were immobilised in a Philadelphia collar for six weeks. This radiological review assessed the postoperative constructs, and the final follow-up radiographs. RESULTS: Overall radiological union was achieved in 90% of cases at an average of 3.8 months. Patients with good constructs had a union rate of 100%. Those with poor constructs had a 25% union rate. Poor results included delayed union, cervical kyphosis, graft migration and loss of screw fixation. CONCLUSION: Poor results in this study were related to operative technique. With good operative technique, excellent results can be expected. Therefore, anterior cervical corpectomy and locked plating alone, with Philadelphia collar immobilisation, appears to be a safe and cost-effective alternative in the management of these fractures.