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The choice of surgical approach for treatment of cervical fractures

OBJECTIVE: to define the epidemiologic characteristics of the involved patients, to classify the subaxial fractures to study how the patients have been surgically treated, with the chosen surgical approach (anterior, posterior or combined) being the main goal of the study, gathering these data in order to observe patterns of treatment for better care of the patient. METHODS: the medical history of 222 patients with cervical fractures, fracture-dislocations and dislocations, between the year of 2004 and March 2009, was retrospectively analyzed. Among these 222 patients, 163 of them had subaxial fractures that were eligible to the AO Classification system, corresponding to 73.4% of the total. RESULTS: 83% of the patients were male and approximately 78% were aged between 21 and 60. Fifty-four patients were classified as Type A, and 50% had surgery - 85,18% by anterior approach, with corpectomy associated or not with arthrodesis; 77 patients were classified as Type B, and 85,7% had surgery - 77,3% by posterior approach, considering the ligament lesion; 21 patients were classified as Type C, and 81% had surgery - 94,1% posterior approach; finally, 11 patients were classified as Multiple Level, and 54,5% had surgery - 83,3% by posterior approach, none by anterior approach alone. CONCLUSION: the data obtained may contribute to the standardization of the care given to the cervical traumatized patient and make the treatment results more predictable. The experience gathered and converted to numbers will help in the choice of the surgical approach.

Spinal fracture; Spinal fracture; Dislocations; Surgical procedures, operative


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