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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med Chin    2009, Vol. 3 Issue (1) : 45-48     DOI: 10.1007/s11684-009-0019-4
RESEARCH ARTCILE |
Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation
Chengwei JING1, Qin FU2, Xiaojun XU2()
1. Department of Orthopedics, Second Hospital of Tianjin Medical University, Tianjin 300211, China; 2. Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang 110004, China
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Abstract  

This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, t = 2.800, P<0.05; improved scores of cases with iliac bone grafting, t = 3.270, P<0.05), and reliable reconstruction of cervical spine. The two groups obtained the same curative effect (t = 0.470, P >0.05) Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

Keywords central cord syndrome      decompression, surgical      titanium mesh     
Corresponding Authors: XU Xiaojun,Email:dr1722@163.com   
Issue Date: 05 March 2009
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-009-0019-4     OR     http://academic.hep.com.cn/fmd/EN/Y2009/V3/I1/45
Fig.1  Lateral X-ray of vertebrae after short mesh grafting in the intervertebra
no.preoperativescores of JOAXi1postoperativescores of JOAXi2improved scores of JOAd= Xi2-Xi1
1473
25127
34139
45127
57147
67169
77158
89167
911176
1015172
Tab.1  JOA evaluation of the cases with titanium mesh bone grafting
no.preoperativescores of JOA Xi1postoperativescores of JOA Xi2improved scores of JOA d= Xi2-Xi1
1583
24139
37136
48135
57158
68168
78179
89178
Tab.2  JOA evaluation of the cases with iliac bone grafting
Fig.2  MRI showing the C5 disk was ruptured and anterior longitudinal ligament with the short ligament broken by an anterior hematoma
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