Fractures of cervical spine with neurological lesion treated by reduction and fixation with plates

A series of 61 cases of cervical spine fracture and dislocation with neurological deficit treated operatively were reviewed. All were reduced and internally fixed with plates and screws. The operative technique was not easy and required a great deal of care and experience. Surgery did not significantly alter the neurological recovery in 12 cases with root involvement and 23 cases with complete tetraplegia. Neurological recovery seemed to be better after surgical intervention in the case of incomplete tetraplegias; 18 out of 26 being able to walk eventually. The main value of surgical fixation of these injuries was to allow early rehabilitation without any external cervical support. However, intensive care of the neuro-cardio-respiratory complications in the post-operative period was necessary to evert the high risk of mortality and morbidity from surgery.