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Abstract
Structured Abstract: Study Design. Prospective cohort study
Objective. This study investigates the results of long posterior instrumentation with regard to complications and survival.
Summary of Background Data. Fractures of the cervical spine and the cervicothoracic junction related to ankylosing spinal disease (ASD) endanger both sagittal profile and spinal cord. Both anterior and posterior stabilisation methods are well established, and clear treatment guidelines are missing.
Methods. 41 consecutive patients with fractures of the cervicothoracic junction related to ASD were treated by posterior instrumentation. All patients were followed prospectively for two years using a standardised protocol.
Results. 5 patients suffered from postoperative infections, 3 patients suffered from postoperative pneumonia, 2 patients required postoperative tracheostomy, and 1 patient had postoperative cerebrospinal fluid leakage due to accidental durotomy. No patient required re-operation due to implant failure or non-union. Mean survival was 52 months [95% CI: 42-62]. Survival was affected by patient age, gender, smoking, and spinal cord injury.
Conclusions. Patients with ASD suffering from a fracture of the cervicothoracic region are at high risk of developing complications. The posterior instrumentation of cervical spinal fractures related to ASD is recommended due to biomechanical superiority.
(C) 2014 by Lippincott Williams & Wilkins
Abstract
Structured Abstract: Study Design. Prospective cohort study
Objective. This study investigates the results of long posterior instrumentation with regard to complications and survival.
Summary of Background Data. Fractures of the cervical spine and the cervicothoracic junction related to ankylosing spinal disease (ASD) endanger both sagittal profile and spinal cord. Both anterior and posterior stabilisation methods are well established, and clear treatment guidelines are missing.
Methods. 41 consecutive patients with fractures of the cervicothoracic junction related to ASD were treated by posterior instrumentation. All patients were followed prospectively for two years using a standardised protocol.
Results. 5 patients suffered from postoperative infections, 3 patients suffered from postoperative pneumonia, 2 patients required postoperative tracheostomy, and 1 patient had postoperative cerebrospinal fluid leakage due to accidental durotomy. No patient required re-operation due to implant failure or non-union. Mean survival was 52 months [95% CI: 42-62]. Survival was affected by patient age, gender, smoking, and spinal cord injury.
Conclusions. Patients with ASD suffering from a fracture of the cervicothoracic region are at high risk of developing complications. The posterior instrumentation of cervical spinal fractures related to ASD is recommended due to biomechanical superiority.
(C) 2014 by Lippincott Williams & Wilkins