Fracture subluxation or traumatic spondylolisthesis of sub-axial cervical spine is
a common but serious spinal injury encountered by neurosurgeons. It is frequently
associated with spinal cord injury. Although decompression of spinal cord either anteriorly
or posteriorly depending upon the site of compression is straight forward, there is
no consensus regarding the approach for stabilization of spine either anterior or
posterior or both, after decompression of spinal cord. Circumferential fusion involves
combined anterior and posterior stabilization of sub-axial cervical spine. Some of
the cases of circumferential fusion performed by the author are presented here. Anterior
stabilization was performed with titanium cage or iliac graft insertion at corpectomy
or discectomy site along with Anterior cervical plating and posterior stabilization
was performed with Apofix clamps or interspinous wiring (cable) or lateral mass plating.
Also one patient in whom only anterior stabilization was performed but who had recurrence
of dislocation is also cited as an example of inadequacy of only one approach of stabilization
to a 3 column cervical spine injury.
Keywords
circumferential fusion - cervical fracture subluxation - paraplegia - quadriplegia
- spinal injury - spinal fusion
