M O al Baz1, N Mathur. 1. Department of Trauma and Orthopaedic Surgery, King Fahd Hospital, Jeddah, Saudi Arabia.
Abstract
STUDY DESIGN: This study evaluated simple modifications in tension-band wiring for 52 patients with acute flexion injuries of the middle and lower cervical spine. OBJECTIVE: To determine the usefulness and effectiveness of a modified technique for stabilizing unstable flexion injuries of the cervical spine. SUMMARY AND BACKGROUND DATA: The prevalent surgical techniques of Segal et al and Davey et al fix unstable injuries of the cervical spine by passing two transverse "K" wires through the skin and the spinous process itself, with tricortical iliac crest grafts placed on the sides. This is supplemented with "figure of 8" wiring for long-term stability. METHODS: Fifty-two patients with acute flexion injuries of the cervical spine were fixed with tension-band wiring with slotted grafts placed over the "K" wires and passed through the spinous process, instead of the "K" wire being passed through grafts. RESULTS: Patients free of neurologic symptoms achieved mobility early with the cervical collar. All patients achieved posterior bony fusion. There was no migration or rupture of tension bandwires or tricortical graft in our series. CONCLUSIONS: The modifications used were simple to apply and resulted in good fixation and fusion in patients with acute flexion injuries of the cervical spine.
STUDY DESIGN: This study evaluated simple modifications in tension-band wiring for 52 patients with acute flexion injuries of the middle and lower cervical spine. OBJECTIVE: To determine the usefulness and effectiveness of a modified technique for stabilizing unstable flexion injuries of the cervical spine. SUMMARY AND BACKGROUND DATA: The prevalent surgical techniques of Segal et al and Davey et al fix unstable injuries of the cervical spine by passing two transverse "K" wires through the skin and the spinous process itself, with tricortical iliac crest grafts placed on the sides. This is supplemented with "figure of 8" wiring for long-term stability. METHODS: Fifty-two patients with acute flexion injuries of the cervical spine were fixed with tension-band wiring with slotted grafts placed over the "K" wires and passed through the spinous process, instead of the "K" wire being passed through grafts. RESULTS:Patients free of neurologic symptoms achieved mobility early with the cervical collar. All patients achieved posterior bony fusion. There was no migration or rupture of tension bandwires or tricortical graft in our series. CONCLUSIONS: The modifications used were simple to apply and resulted in good fixation and fusion in patients with acute flexion injuries of the cervical spine.
Authors: Jonathan N Sellin; Kashif Shaikh; Sheila L Ryan; Alison Brayton; Daniel H Fulkerson; Andrew Jea Journal: Childs Nerv Syst Date: 2014-03-11 Impact factor: 1.475