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  4. Outcome and complications of operatively treated subaxial cervical spine injuries: A population-based retrospective cohort study

Outcome and complications of operatively treated subaxial cervical spine injuries: A population-based retrospective cohort study

World Neurosurgery: X, 2024 · DOI: https://doi.org/10.1016/j.wnsx.2024.100283 · Published: March 1, 2024

SurgeryTraumaOrthopedics

Simple Explanation

This study examines the results of surgical treatment for injuries to the lower part of the neck (subaxial cervical spine). It looks at how well the surgery worked and what problems occurred, depending on the type of injury and the surgical method used. The study reviewed the cases of 271 patients who had surgery for these injuries at Kuopio University Hospital between 2003 and 2018. The results showed that surgery can be safe and effective, but the best surgical approach should be chosen based on the patient's specific injury. Patients who still had some motor function before surgery had a better chance of regaining neurological function.

Study Duration
2003 to 2018
Participants
271 consecutive patients
Evidence Level
Not specified

Key Findings

  • 1
    Fixation alignment was maintained in 96.9% of patients, indicating a high success rate in stabilizing the spine.
  • 2
    Patients with preoperative AIS grade C had significant potential for neurological improvement (OR 10.44; 95% CI 1.77–61.56; p = 0.010).
  • 3
    The posterior approach was associated with fewer postoperative complications (OR 0.18; 95% CI 0.06–0.51; p = 0.001).

Research Summary

This population-based cohort study with 271 patients showed that surgical treatment of SCSIs provides excellent outcomes. The surgical approach did not affect the outcome of surgery, but the different approaches had individual complication profiles. SCSIs with AIS grade C had a notable potential for rapid neurological improvement after surgery.

Practical Implications

Personalized Surgical Approach

Surgeons should tailor the surgical approach to the specific patient and injury characteristics to optimize outcomes and minimize complications.

Neurological Recovery Potential

Patients with partial spinal cord injuries (AIS grade C) should be prioritized for active treatment and rehabilitation due to their higher potential for neurological improvement.

Posterior Approach Consideration

The posterior surgical approach should be considered to reduce the risk of postoperative complications.

Study Limitations

  • 1
    Retrospective study design
  • 2
    Variation in follow-up and imaging protocols
  • 3
    Limited availability of MRI at the beginning of the study period

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