Risk factor prognosticating single centre outcome study of 75 cases of cervicodorsal fracture dislocations

Acute traumatic fracture-dislocations at the cervicothoracic junction are rare, accounting for 9% in cervical injuries. Presented herewith is a prospective cum retrospective study of 75 patients with C6 to D2 traumatic fracture dislocation operated over two year period at a level 1apex trauma centre in India. Mean age at presentation of 38.5 years (range 6-80 years). In 34% of patients injury resulted from high velocity trauma, whereas 66% suffered from low velocity trauma. Complete cord injury was seen in 53 patients (70.7%) while the rest 22 patients (29.3%) had incomplete cord injury. MRI signal change was noted in 67% cases. Mean pre operative Frankel score was 1.84 and mean post operative Frankel score was 2.07. Mean Sub-axial injury Classification score (Vackaro) was 6.22. Most of the patients (89%) were operated by anterior approach. About two thirds of all patients were ventilator dependent on prolonged follow up. There was improvement in motor function in post operative period in 10% (n=8) patients whereas 1 patient had deterioration. Mortality rate during hospital stay was 17 % (n=13). Low velocity trauma is the most common cause of cervicodorsal fracture with significant social impact as the young population is mostly involved and cervicodorsal injury resulted in significant deficits. Anterior surgical approach is safe and effective.