Posterior wiring without bony fusion in traumatic distractive flexion injuries of the mid to lower cervical spine. Long-term follow-up in 30 patients.

Abstract

Thirty-four patients with traumatic distractive flexion injuries in the mid to lower cervical spine were treated with posterior wire stabilization without bony fusion from January 1981 through May 1987. Fifteen had cord involvement, and nine had root involvement. Ten were neurologically intact. Thirty patients were followed for a mean of 38 months. Two neurologically intact patients had root deficits postoperatively. One patient was reoperated because of redislocation due to a spinous process fracture. Mean loss of lordosis was 7.5 degrees. Eight patients had a wire break at follow-up, but no case of late instability was observed. Sixteen patients had signs of spontaneous anterior interbody fusion at follow-up, and 11 patients had signs of posterior fusion. Twenty-four patients complained of late--but in most cases--minor pain. These results indicate that simple posterior wiring without bony fusion is a reliable method to obtain good immediate stability in traumatic distractive flexion injuries of the mid to lower cervical spine. The wires provide sufficient stability during the time of soft tissue healing.