ONE-STAGE ANTERIOR CERVICAL DECOMPRESSION AND POSTERIOR STABILIZATION- A STUDY OF 100 PATIENTS WITH A MINIMUM OF 2 YEARS OF FOLLOW-UP

One hundred patients were managed with one-stage anterior decompressio n and posterior stabilization of the cervical spine, The underlying in dication for the operation was cervical trauma in thirty-one patients; a neoplasm with a pathological fracture or an incomplete neurological deficit in fifty-five; and a miscellaneous condition, such as infecti on, rheumatoid arthritis, or cervical spondylotic myelopathy, in fourt een, The duration of follow-up ranged from twenty-four to 108 months ( mean, thirty-two months) for the living patients, Sixteen patients had the procedure after the failure of an operation that had been perform ed elsewhere, The development of more biomechanically rigid cervical i nstrumentation did not obviate the need for a combined anterior and po sterior approach, Twenty-six patients (26 per cent) had supplemental c ervical instrumentation as part of the circumferential arthrodesis: se venteen had insertion of an anterior cervical plate and nine had inser tion of a posterior facet plate. There were no iatrogenic neurological deficits. Of the seventy-five patients who had had a neurological def icit preoperatively, fifty-one improved one grade and six improved two grades according to the system of Frankel et al, Of the thirty-five p atients who had not been able to walk preoperatively, twenty-one regai ned enough motor strength to walk postoperatively. Because the anterio r and posterior procedures were performed during one session of genera l anesthesia, the prevalence of perioperative complications related to the airway was lower than that previously reported in the literature, No patient had an obstruction of the airway.