Khurram Ishaque, Amir Aziz, Zubair Ahmed, Yaser-ud Din Hoti, Tariq Salah-ud Din.
Outcome of Anterior Fixation in Lower Cervical Spine Injuries.
Pak J Neuro Surg Jan ;19(3):184-8.

Introduction: The fractures of cervical spine are divided into upper cervical spine (C1 – C2) and lower cervical spine (C3 – C7) fractures, also called sub-axial cervical spine. Sub-axial cervical injuries rangesfrom minor ligamentous strain or spinous process fracture to complete fracture dislocation with bone and ligament disruption, resulting in severe spinal cord injury. Objectives: The objective of this study was to determine the efficacy of anterior cervical spine fixation as regards the effective stabilization, immobilization and solid bony fusion in lower cervical spine injuries by the use of cervical spine locking plate (CSLP) attached with cancellous screws. Study Design: Descriptive case series study. Materials and Methods: This study was conducted from March 2013 to March 2014 in the department of Neurosurgery unit II, Lahore General Hospital Lahore. A total of 30 patients were included in this study of both gender and in the age range of 16 – 60 years. Results: In our study, there were 23 (76.7%) male patients and 7 (23.3%) female patients. The majority of the patients 25 (83.3%) were in the age range of 21 – 50 years with mean age was 38.2 ± 11.7 years. On one month follow up, the mean Frankel grade was 3.5 ± 1.6, 3.53 ± 1.6 on 3 months follow up and 3.6 ± 1.8 on 6 months follow-up. Similarly, 12 (40%) patients remained catheterized, 16 (53.3%) patients had normal control and 2 (6.7%) patients had partial recovery in 1 month time. After 3 months, 4 (13.3%) patients remained catheterized, 20 (66.7%) patients had normal control and 6 (20%) patients had partial recovery. After 6 months 3 (10%) patients remained catheterized, 25 (83.3%) patients had normal control and 2 (6.7%) had partial recovery. On follow up of one, three and six months, x-ray finding showed in 9 (30%) patients of good condition and 21 (70%) patients of satisfactory condition. Conclusion: The use of anterior approach in treatment of the injured lower spine is safe and effective. Abbreviations: CSLP = cervical spine locking plate.

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