Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations

Abstract

Objective. To identify factors leading to the loss of correction and redislocation of the vertebrae after isolated anterior reconstruction and stabilization in the surgical treatment of subaxial cervical dislocations. Material and Methods. A retrospective cohort STROBE-type study was carried out using data of 175 patients with dislocations of vertebrae in the subaxial cervical spine who were operated on in 2010–2019. The key parameters of the study were the relevant indices of the cervical sagittal balance and morphological characteristics of the injury: thoracic inlet angle (TIA), T1 vertebra slope, neck tilt, regional cervical C2–C7 lordosis, fracture of the vertebral body, and fracture of the articular process at the level of dislocation. Statistical analysis of the obtained data was carried out in the RStudio program. Results. At preoperative TIA value of 74.5°, the risk of correction loss corresponds to 28 %. In the group with TIA 0.05). Conclusion. The parameter of the cervical sagittal balance, thoracic inlet angle, as well as the fracture of the articular process at the level of injury are statistically significant factors that determine the initial stability in isolated anterior surgical reconstruction and stabilization of the lower cervical spine for Allen type 3 flexion-distraction injuries.

Keywords

• anterior cervical discectomy and stabilization
• anterior spinal fusion
• cervical sagittal balance
• dislocations of cervical verte- brae
• recurrent dislocation
• re-dislocation
• loss of correction
• flexion-distraction injury