Anterior Fusion with Caspar Plating in Traumatic Cervical Spine Instability.

Lee, Sung Un; Gill, Seung Bae; Jang, Yeun Gyu; Lee, Sang Youl

Original Article

Journal of Korean Neurosurgical Society 2004;35(3): 256-260.

Sung Un Lee, Seung Bae Gill, Yeun Gyu Jang, Sang Youl Lee

Department of Neurosurgery, Gang Neung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea. lsuon@orgio.net

ABSTRACT

OBJECTIVE
In these retrospective studies, the authors report an evaluation of clinical and radiological outcome in patients with cervical spine injury who underwent anterior cervical fusion with Caspar Plating system. METHODS: The authors studied 45 patients with unstable cervical spine after trauma between July 1996 and December 2001. Our series consist of 39 male and 6 female. The cervical spine injury was most common in men in fourth decade. Motor vehicle accidents were a frequent cause of cervical spine injury. Thirty-three patients had fractures with instablity, ten a ligamental injury without fracture, one traumatic hernated disc. Lateral cervical spine X-rays were reviewed for evaluation of fusion and instrumentation failure. RESULTS: In most cases, operation for stabilization was done around one weeks after trauma. In all patients excellent immediate postoperative stability of the spine was obtained, although posterior fusion was necessary at same time in one patient. Solid fusion was achieved in all except two patients who died during the first 2 months after the operation. Three patients developed instrumentation related failure(6.7%): Two patients had screw loosening, one infection. Two of these patients underwent reoperation. The most dreaded complication of dural or cord penetration by drilling or screw placement was not observed. There was no postoperative neurological disturbances. Four patients died of causes unrelated to operation: Two patients died of upper gasterointestinal bleeding, and the other two died of pneumonia and sepsis respectively. CONCLUSION: The Caspar plating system affords an effective means of improving the fusion rate with acceptable instrumentaton-related morbidity in cervical spine injury.

Key Words: Cervical spine injury; Anterior cervical fusion; Caspar plate; Instrumentation failure