Türk Nöroşirürji Dergisi 1998 , Vol 8 , Num 2
Mehmet ZİLELİ1, Erdal COŞKUN2, Sertaç İŞLEKEL1, Kazım ÖNER1, İzzet ÖVÜL1, Nurcan ÖZDAMAR1
1Ege Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, İzmir
2Pamukkale Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, Denizli
Fourty-five patients with cervical traumatic locked facets were treated at the Department of Neurosurgery of Ege University School of Medicine during 14 years period (1978-1992). In 33 patients there were unilateral and in 12 patients bilateral locked facets. Most of the dislocations were at C6-C7 level (38%). All patients underwent a closed skeletal traction initially. For the cases that the reduction was successful, bone fusion with anterior approach was used. During the last years, this procedure was combined with a plate stabilization. If the reduction was not successful via skeletal traction, a posterior surgery together with an open reduction and instrumentation was applied. In 15 cases stabilized with anterior approach, 9 patients developed deformity, and 3 of them were operated again with posterior stabilization and 2 had a Halo jacket. In 30 cases treated with posterior approach, 9 patients have developed deformity, of which 3 had a Halo jacket. In general, we achieved closed reduction in approximately 40% of the patients who had skeletal tractions during the first 7 days of their injury. However, none of the patients receving skeletal tractions were reducted after 7 days. Presence of a facet fracture also did not effect the reduction. In conclusion, traumatic cervical locked facets is a serious trauma type with high morbidity. There is no simple algorhytm for these cases. Anahtar Kelimeler : Cervical Fracture, cervical locked facet, frankel scores, spinal cord injuries