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Year : 2014  |  Volume : 21  |  Issue : 1  |  Page : 61-65

Outcome of surgery for upper cervical spine injuries in Nigerians

1 Department of Surgery, College of Medicine, University of Ibadan; Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria
2 Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria

Correspondence Address:
A A Adeolu
PO Box 40476, Dugbe, Ibadan
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Source of Support: None, Conflict of Interest: None

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Aims and Objectives: . This is a review of the initial experience with surgical management of upper cervical spine injuries. Materials and Methods: The clinical case notes of patients surgically managed for UCSI were analysed for aetiology, presentation, duration of symptoms before presentation and surgery, pre- and post-operative Frankel grading, nature of injury and type of surgery. Results: Eleven male and one female patients (mean age; 41.8 years; range 22-58 years) with UCSI were managed surgically. All the patients were involved in road traffic crashes. The case distribution were odontoid peg fracture [type II] alone (2 cases), hangman fracture alone (5 cases), both C1/2 subluxation and odontoid peg fracture (4 cases) and complex C2 injury (1 case). The surgical management includes C1 posterior ring excision and occipitocervical fusion [C0 - C4] (one patient), modified Gallie fusion alone (six patients), combined modified Gallie fusion and Rogers interspinous wiring (three patients). One patient each had C1/C2 interspinous wiring and combined modified Gallie fusion and occipito-cervical fusion [C0 - C4]. Post-operatively, two patients improved from Frankel C to D, 2 patients from C to E and one patient from D to E. The other patients with Frankel D and E injuries pre-operatively remained in status quo post-operatively. Eleven of the patients were discharged home on progressive ambulation with one having neck stiffness and one patient died 7 weeks post- surgery. Conclusion: Odontoid peg and hangman fractures were the most common indications for upper cervical spine surgery for trauma in our unit, and the post- operative outcome appears satisfactory.

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