aado cervical surgical approaches
TRANSCRIPT
overview of surgical approaches for cervical spine injury
AADO Trauma Series I - Spinal Injury Workshop OLC, PWH Feb 2014
Dr Kin Cheung MAK Associate ConsultantDepartment of Orthopaedics & TraumatologyQueen Mary Hospital University of Hong Kong
outline
axial
open mouth
posterior
subaxial
anterior
posterior
dens fracture classificationtype I - avulsion, alar ligament, collar
type II - 30-50% non-union, esp. > 65 y-o, > 5mm displacement or 10° angulation
type III - may heal with immobilisation (halo jacket) but need 12 wks; screw is option
subaxial cervical spine fracture classification
Sub-axiaL Injury Classification (SLIC) & Severity Scale
comprehensive - morphology, neurology, disco ligamentous complex
prognosis
management
earlier classification systems
Harris, Ferguson & Allen
posterior cervical approach
posterior approaches
midline dorsal
C3-7
occipitocervical
lateral mass screw
pedicle screw
C1/2 fixation
C1/2 fusion options
anterior cervical approach
anterior approaches
open mouth
high anterior
workhorse - Smith Robinson (anterolateral)
extended approaches - sternotomy, manubriectomy
Smith-Robinson (anterolateral)
manubriectomy
high cervical
dens screw
open mouth
summary:posterior cervical approach
midline
extend cephalad or caudal
anterior cervical approach
anterolateral (Smith-Robinson)
high cervical & open mouth
manubriectomy/sternotomy