Surgical Treatment of Upper Cervical Spine Trauma: Experience in a Regional Neurosurgery Unit in a Country with Limited Health Care Resources—About 22 Consecutives Cases

Abstract

Objectives Representing approximately 22% of cervical spine injuries, upper cervical spine injuries are becoming more frequent with the increase in road traffic accidents. The purpose of our study is to evaluate the results of our surgical series and to compare them with the literature.

Materials and Methods In this monocentric retrospective study of over three years (June 2019–May 2022), all the patients with traumatic injuries of the upper cervical spine with a surgical treatment and a minimum of 12 months follow-up were included.

Results The average age was 32.7 years, with a predominance of young patients. The predominant cause of injury was road traffic accident (86.3%). The clinical symptoms were cervical pain, associated with a motor deficit in two cases. Jefferson fracture associated with odontoid fracture was the most frequent injury (36.3%), followed by Hangman fracture (22.7%). Ten patients were treated with the Harms technique, four with occipitocervical C0-C2-C3 fixation, two with anterior screw insertion of the odontoid, and six with anterior C2-C3 arthrodesis. The average duration of follow-up was 12.2 months. The outcome was favorable in 21 cases and average in 1 case. Surgical morbidity and mortality were inexistent.

Conclusion This short series shows the effectiveness of surgical treatment in the managing traumatic injuries of the upper cervical spine and in the regression of the pain with a low risk of surgical morbidity and mortality.

Keywords

upper cervical spine - trauma - surgical treatment - regional neurosurgery unit - limited health care resources

Authors' Contributions

M.F., L.F.B., and R.M.I. conceptualized the article. V.N., E.C.N.S., A.D., T.Y.A.D., H.G.A., Y.C., D.W., I.B.K., and M.G. gathered the data. All the authors revised the article and approved the final draft of the article that was submitted. M.G. provided guidance toward the completion of the article.

This study was approved by the ethics committee of the regional hospital of Thies (Republic of Senegal).

Publication History

Article published online:
13 September 2023

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