Management of Unilateral Cervical Facet Joint Dislocation in Neurologically Intact Patients: Results of an Ao Spine latin American Survey.
Cervical trauma
Facet dislocation
Management
Spinal fracture
Unilateral
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
25
08
2020
revised:
01
10
2020
accepted:
03
10
2020
pubmed:
24
10
2020
medline:
30
6
2021
entrez:
23
10
2020
Statut:
ppublish
Résumé
The treatment of unilateral CFD in patients without neurologic deficits remains controversial, especially in the choice of the best surgical approach. Our objective is to determine the way spine surgeons from Latin America manage this condition. A survey regarding management and surgical strategies was conducted by the AO Spine Latin American Trauma Study Group considering the treatment of unilateral CFD. All AO Spine Latin American Trauma Study Group members were sent a link to the survey, among whom 285 replied, with 197 respondents answering all the questions. Nonsurgical management was considered by 25% of the surgeons. The majority stated that magnetic resonance imaging is necessary (65%) to treat this type of patient. A posterior approach was preferred by 44%, an anterior approach by 29%, and a combined approach by 25%, while 2.2% did not answer. Traction was not used by the majority of respondents (62%). In the setting of an anterior disk herniation, the majority of surgeons preferred to employ an anterior (45%) or combined (44%) approach versus an isolated posterior approach (only 0.5%). Comparing early versus late cervical trauma, fewer surgeons adopted an isolated anterior approach with the latter (29% vs. 15%). Wide variations exist in the management of unilateral CFD by Latin American surgeons, with early injuries generally treated using either an anterior or posterior approach and treated early but after an MRI, while a combined approach is used more commonly with late injuries. Either an anterior or combined approach is used when disk herniation is present.
Sections du résumé
BACKGROUND
The treatment of unilateral CFD in patients without neurologic deficits remains controversial, especially in the choice of the best surgical approach. Our objective is to determine the way spine surgeons from Latin America manage this condition.
METHODS
A survey regarding management and surgical strategies was conducted by the AO Spine Latin American Trauma Study Group considering the treatment of unilateral CFD.
RESULTS
All AO Spine Latin American Trauma Study Group members were sent a link to the survey, among whom 285 replied, with 197 respondents answering all the questions. Nonsurgical management was considered by 25% of the surgeons. The majority stated that magnetic resonance imaging is necessary (65%) to treat this type of patient. A posterior approach was preferred by 44%, an anterior approach by 29%, and a combined approach by 25%, while 2.2% did not answer. Traction was not used by the majority of respondents (62%). In the setting of an anterior disk herniation, the majority of surgeons preferred to employ an anterior (45%) or combined (44%) approach versus an isolated posterior approach (only 0.5%). Comparing early versus late cervical trauma, fewer surgeons adopted an isolated anterior approach with the latter (29% vs. 15%).
CONCLUSIONS
Wide variations exist in the management of unilateral CFD by Latin American surgeons, with early injuries generally treated using either an anterior or posterior approach and treated early but after an MRI, while a combined approach is used more commonly with late injuries. Either an anterior or combined approach is used when disk herniation is present.
Identifiants
pubmed: 33096282
pii: S1878-8750(20)32203-8
doi: 10.1016/j.wneu.2020.10.011
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e76-e85Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.