caa a22 4500 445832592 CHVBK 20180317145320.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s00586-010-1589-1 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1589-1 Posterior approach for cervical fracture-dislocations with traumatic disc herniation [Elektronische Daten] [Hiroaki Nakashima, Yasutsugu Yukawa, Keigo Ito, Masaaki Machino, Hany El Zahlawy, Fumihiko Kato] In the treatment algorithm for cervical spine fracture-dislocations, the recommended approach for treatment if there is a disc fragment in the canal is the anterior approach. The posterior approach is not common because of the disadvantage of potential neurological deterioration during reduction in traumatic cervical herniation patients. However, reports about the frequency of this deterioration and the behavior of disc fragments after reduction are scarce. Forty patients with traumatic disc herniation were observed. They represented 29.2% of 137 consecutive patients with subaxial cervical spine fracture-dislocations. Surgical planning was performed according to our two-stage algorithm. In the first stage, they were treated with posterior open reduction and posterior spine arthrodesis. In the second stage, anterior surgery was added for cases where neurological deterioration attributed to non-reduced disc fragments on postoperative magnetic resonance imaging (MRI). Neurological deterioration after posterior open reduction was not observed. Furthermore, 25% of total cases and 75% of incomplete paralysis cases improved postoperatively by ≥1 grade in the American Spinal Injury Association impairment scale. Reduction or reversal of disc herniation was observed in all cases undergoing postoperative MRI. For local sagittal alignment, preoperative 9.4° kyphosis was corrected to 6.9° lordosis postoperatively. The disc height ratio was 72.4% preoperatively and 106.3% postoperatively. The second stage of our plan was not required after the posterior approach in this series. The incidence of neurological deterioration after posterior open reduction was zero, even in cases with traumatic cervical disc herniation. Favorable clinical and radiological outcomes could be obtained by the first stage alone. Although preparations for prompt anterior surgery should always be made to cover any contingency, the need for them is minimal. Springer-Verlag, 2010 Traumatic cervical disc herniation nationallicence Cervical spine fracture-dislocations nationallicence Posterior reduction nationallicence Neurological deterioration nationallicence Pedicle screw system nationallicence Nakashima Hiroaki Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut Yukawa Yasutsugu Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut Ito Keigo Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut Machino Masaaki Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut El Zahlawy Hany Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut Kato Fumihiko Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut European Spine Journal Springer-Verlag 20/3(2011-03-01), 387-394 0940-6719 20:3<387 2011 20 586 https://doi.org/10.1007/s00586-010-1589-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1589-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nakashima Hiroaki Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Yukawa Yasutsugu Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Ito Keigo Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Machino Masaaki Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- El Zahlawy Hany Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Kato Fumihiko Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/3(2011-03-01), 387-394 0940-6719 20:3<387 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer