[Surgical treatment after cervical spine and spinal cord injuries of the C3-C7 level]

The authors report the methods and results of the treatment of 83 patients with lower cervical spine (C3-C7) injuries, who were treated in the Neurosurgery Department in Elblag in a period of 11 years. Lesions ranged from fractures mainly of vertebral C5 and C6 bodies, and dislocations--mostly at levels C4-C5 and C5-C6. Most lesions were the consequence of a headlong jump into water (38.5%) and traffic accidents (29%). In admission sensory disturbances (38.5%) and tetraplegia or paresis of the upper limbs with paralysis of lower limbs (together 44.6%) were most frequently observed. The state of the patients was evaluated according to the ASIA-Frankel's scale. 148 surgical procedures were carried out. Decompression and autogenic and/or plate stabilization--from the anterior approach using Caspar's system and Crutchfield's traction--were the preferred methods. The post-surgical follow up extends from 9 years to 3 months. The most satisfying result was the improvement observed in the patients from groups A and B according to ASIA-Frankel's scale. Among 36 such patients, the medullary functions of 17 patients improved. 14 patients died from 5 days to 3 months after surgery. The authors also present an overview of contemporary management of lower cervical spine injuries. The emphasis is placed on the importance of factors making the treatment of spine and spinal cord injuries more difficult and delaying the beginning of early and efficient surgery.