An Innovative Technique for Anterior Cervical Surgery in Sub-axial Cervical Fracture Dislocation with incomplete spinal cord injury: A Paradigm Shift in Surgical Approach

Author(s): Shah Alam, Sharif Ahmed Jonayed, Sarwar Jahan, Abdullah Al Mamun Choudhury, O Z M Dastagir

Introduction: Cervical spine injury was the most common cause of spinal cord injury worldwide in 2013, accounting for 43.9% to 61.5% of all cases. Prior to injury, the majority of individuals with a cervical spine injury was in their prime years and led an active lifestyle. The aim of the study was to evaluate the safety & efficacy of the proposed innovative technique to reduce all cases of subaxial cervical fracture-dislocation.

Methods: This was a retrospective study and was conducted in the Department of Orthopaedic Surgery during the period from January 2020 to June 2023. In our study, we included 336 patients with subaxial cervical fracture dislocation who underwent ACDF. We routinely used an anterior approach with a left-sided transverse incision for surgery.

Results: The mean age was 34.61 ± 12.37 years with a male predominance. The most common mechanism of injury was RTA (39.29%) and most common level of fracture at C5/C6 was 38.10%. Mean operative time was 70.2 + 19.1 mins, and mean blood loss 142.72 ± 82.27 ml. The mean NDI improved to 10.7 ± 6.8, VAS improved to 3.1 ± 1.4 at the final followup which showed majority of our patients could return to their daily life activities. Majority (83.04%) of our patients had no complications and dysphagia was 4.17 %. Majority of 236(70.24%) patients had no disability.

Conclusions: In our study, we found that a single anterior approach is a safe and effective procedure for subaxial cervical spine dislocation treatment with satisfactory radiological, neurological and functional outcomes.