Clinical observation of anterior decompression bone grafting and internal fixation in the treatment of lower cervical dislocation and analysis of influencing factors of early postoperative complications.

Objective: To investigate the effect of anterior decompression with bone graft and internal fixation for dislocation of lower cervical vertebra, and to analyze the influencing factors of early postoperative complications.

Methods: The retrospective study included 90 patients with lower cervical fractures and dislocations who received anterior decompression and internal fixation in our hospital from November 2018 to October 2021. Postoperative indexes, therapeutic effects, postoperative recovery of cervical and spinal functions and complications were observed. Univariate and multivariate Logistic regression analysis was conducted with early postoperative complications as the dependent variable.

Results: All the 90 patients underwent surgical treatment successfully, the operation time was (85.11 ± 11.57) min, the intraoperative blood loss was (148.05±36.75) mL. Compared with preoperative results, Cobb Angle and anterior atlas space were significantly smaller at 6 months and 1 year after surgery (P < 0.05). No broken plate, broken nail and loose plate were observed in the patient one year after surgery, and the bone graft fusion was good. JOA score and ASIA score were significantly improved at 6 months and 1 year after surgery (P < 0.05). ASIA scores of patients with incomplete nerve injury were improved in different degrees 6 months and 1 year after surgery (P < 0.05). Of the 90 patients, 10 had related complications after surgery, with an incidence of 11.11%. The results of multivariate Logistic regression analysis indicated that the time from injury to operation and the longer operation time were both influencing factors of early postoperative complications (P < 0.05).

Conclusion: Anterior cervical approach decompression bone grafting and internal fixation in the treatment of lower cervical fracture and dislocation has remarkable effects, which is helpful to promote the recovery of spinal nerve function. However, postoperative complications still exist, among which the time from injury to operation and the longer the operation time are both influencing factors of early postoperative complications, which should be paid attention to in clinic.