Corpectomy in Sub-Axial Cervical Fracture in Tertiary Center in Third World Country
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- Category: Vol. 89, March 2021
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Corpectomy in Sub-Axial Cervical Fracture in Tertiary Center in Third World Country, MOHAMMED H. ALY, AHMED H. ELASHRY and AMR A.A.M. ELKATATNY
Abstract
Background: Cervical spine injuries represent 5-10% ofmajor injuries in post-traumatic patients. These injuries cause6K deaths and 5K quadriplegic cases annually. The neurolog-ical defect happens due to disruption of the normal anatomy.Aim of Study: Cervical corpectomy is a common spinalsurgery procedure used to decompress the spinal cord innumerous degenerative, traumatic and neoplastic conditions.The aim of this study was to investigate the indications,complications and outcomes in past cervical corpectomy casesat one centre.Patients and Methods: During the period of July 2019- July 2020, corpectomy was performed on 14 patients withlower cervical spine fracture, fracture/dislocation by the authorsurgeons. Etiology for the cervical trauma of 14 patients wasroad traffic accidents. A standard anterior approach to thecervical column was applied to remove affected vertebraeand discs, including their upper and lower surfaces. Corpec-tomy was done with rounger and high-speed drills with imageguidance. A PIRA mesh filled with bone was inserted into thespace created by body and discs removed. A plate was inserted.Results: In our series, 12 (85.7%) were incomplete mye-lopathy (Grade III, IV, V). 7 of them improved after surgery (58.3%), 3 unchanged (25%), 2 passed away (16.7%). Wehave 2 patients (14.3%) with grade VI, of them 1 patientimproved (50%) and the other one did not improve (50%).we have 12 patients (85.7%) operated in 24 hours after trauma. 8 of them improved (66.7%) and they were all the patients who were improved from the total (8/14, 57.14%). 2 cases only were postponed later than 24 hours. We have 2 patients had wound infection (14.3%), 2 CSF collections (14.3%), 2 patients had difficulties in breathing (14.3%), 4 patients suffered from bed sores (28.6%). So total patients with complications were 8/14 (57.14%). Four patients stayed 48 hours (28.6%), 8 patients (57.1 %) stayed for 72 hours. And 2 patients stayed more than 72 hours (14.3%).Conclusion: We do not have actual number of incidencesof road traffic accidents, but all our cases are due to accidents.We have C5 fracture was the most common segment. Mostcommon age group affected was 21-30 with male predominance. Better neurological state pre-operative favors theoutcome post-operative. Early surgery especially in 24 hourswas related to clinical improvement. Decreasing infectionmay decrease mortality and improving the outcome. Shorterstay in ICU (less than 72 hours) post-operatively is a predictorfor better outcome.