CDA surgery stabilized C5/6 vertebrae and increased the CROM and horizontal displacement of upper adjacent C4/5 vertebrae.

The aim of the article is to investigate the efficacy and safety of 1-stage surgical therapy via combined anterior-posterior approach on cervical spine fracture in patients with ankylosing spondylitis (AS).We retrospectively analyzed profiles of 12 AS patients with severe fracture-dislocation of cervical spine received 1-stage combined anterior-posterior surgery in our hospital from October, 2013, to October, 2015, including clinical characteristics, follow-up data, and imaging records. We compared the parameters before and after surgery on the basis of neurological function, bone fusion, Cobb angles of operation segment, Barthel index (BI) score, and incidence rate of complications.A total of 12 patients received 1-stage surgery via combined anterior-posterior approach within 3 days after injury. No severe complications and death occurred. All patients received the successfully anatomical reduction of fracture-dislocation, in which 9 achieved function restoration. The latest follow-up showed the neurological function status of patients was improved. The Cobb angles of operation segments were recovered; the rate of bone fusion was 66.7% at 3 months and 100% at 6 months post-operation. The BI score was improved, 4 cases of moderate dependence and 8 of slight dependence at the latest follow-up compared to 10 of severe dependence and 2 of moderate dependence preoperation. In no cases did severe complications from implanted instrumentation occur.It was high efficacy and safety that the surgical therapy was performed on cervical fracture-dislocation in AS patients by the 1-stage combined anterior-posterior approach. The key of the surgery is the robust stabilization and full decompression of fracture spine at early stage. In addition, if spinal anatomical reduction of fracture segments is difficult to be achieved, the functional restoration should be adopted during the surgery.

[目的]总结伴颈性眩晕颈椎病患者手术疗效,探索该类患者手术治疗指征及手术要点.[方法]收集本院2010年1月～2014年12月伴颈性眩晕颈椎病患者127例,并根据性别、年龄、手术入路、手术节段、术前眩晕评分及术后颈椎前凸角进行分组,统计并比较各组患者改善率及改善度差异.[结果]女性、前路手术及术前评分超过3分患者改善率及改善度明显提高.长节段(＞2个)、术后颈椎前凸角超过10°患者改善率显著提高,但改善度差异无统计学意义.年龄超过60岁患者改善度显著低于年龄低于60岁患者.[结论]保守治疗无效、女性患者、年龄不超过60岁及眩晕评分超过3分可作为重要的手术指征.尽量选择前路手术,长节段固定不稳定的椎体,重建颈椎曲度有助于提高患者的改善率及改善程度.