Management
In a study of 102 patients [PMID:32624368], anterior surgical intervention led to significant improvements in pain (VAS scores), kyphosis correction, and functional outcomes (Neck Disability Index), with 90.2% achieving good to excellent outcomes.
In this prospective study [PMID:24346051], 3 out of 9 patients with moderate stenosis underwent closed reduction followed by anterior cervical discectomy and fusion, indicating a viable surgical approach for such cases.
Five patients with severe stenosis received a primary combined anterior and posterior operation, which included circumferential release, posterior reduction, and fixation followed by anterior fusion, as reported in [PMID:24346051].
Fifteen patients underwent direct posterior C1-2 fusion after pre-operative reduction via skull traction, while eight patients achieved reduction solely through skull traction under general anesthesia, followed by immediate fusion [PMID:21507654].
Complications
Three patients (3%) in the study required supplementary posterior reduction procedures despite initial anterior fusion [PMID:32624368].
The research by Jiang et al. [PMID:24346051] noted that no severe complications were observed among the 14 patients treated surgically, highlighting the safety profile of the described procedures.
No complications such as dural tears, spinal cord damage, vertebral artery damage, implant breakage, or loosening were reported in the study [PMID:21507654].
Prognosis & Follow-up
Patients in the study demonstrated lasting clinical benefits with mean follow-up of 12.4 years, evidenced by reduced VAS scores, improved kyphosis angles, and decreased NDI scores [PMID:32624368].
All patients achieved solid bony fusion with significant clinical improvement as measured by Di Lorenzo's grades and Japanese Orthopedics Association scores over follow-up periods ranging from 5 to 72 months [PMID:21507654].
References
1 Ren C, Qin R, Li Y, Wang P. Anterior reduction and fusion for acute unilateral cervical facet dislocation without severe spinal cord injuries. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2020. link 2 Jiang X, Cao Y, Yao Y, Chen X, Guan J, Zhang F. Surgical Management of Old Lower Cervical Dislocations With Locked Facet. Clinical spine surgery 2016. link 3 Li XF, Yang HL, Jiang WM, Tang TS, Gong XH, Yuan J et al.. Combination of skull traction with posterior C1-2 fusion for old C1-2 dislocations. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2011. link