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Journal of Korean Neurosurgical Society > Volume 26(6); 1997 > Article
Journal of Korean Neurosurgical Society 1997;26(6): 787-792.
Anterior Cervical Fixation in Spine Injury Patients Requiring Tracheostomy.
Hyun Sik Jung, Joo Kyung Sung, Dae Hyun Kim, Sung Kyoo Hwang, In Suk Hamm, Yeun Mook Park, Seung Lae Kim
Department of Neurosurgery, College of Medicine, Kyungpook University, Taegu, Korea.
ABSTRACT
Because of the possibility of increased the risk of soft tissue or bone infection, surgeon have been somewhat reluctant to use the anterior cervical approach in spinal injury patients who had previously undergone tracheostomy. The authors investigated whether the use of a Caspar plate in such patients during anterior cervical fixation altered the risk of infection. We analyzed the mechanism and level of injury, operative procedures, post-operative course and infection in 12 cervical injury patients with previous tracheostomy. The procedure had been performed on the day of injury because of semicoma resulting from combined head injury in two cases, and because of multiple rib fracture with hemothorax, and old age with chronic obstructive lung disease in one case each; it had been performed between 1-6 days after injury because of high fever with pneumonia and atelectasis in eight cases. The interval between tracheostomy and anterior fixation was 5-20(average, 13) days. During clinical follow-up at 8-21 (average, 16) months, bone union without infection was observed in all patients. The authors concluded that in patients with cervical cord injury, tracheostomy did not increase the risk of infection in subsequent anterior cervical fixation using a Caspar plate.
Key Words: Anterior cervical fixation; Tracheostomy; Respiratory failure
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