Management of Unilateral Cervical Facet Joint Dislocation in Neurologically Intact Patients: Results of an Ao Spine latin American Survey.

Autor: Joaquim AF; Department of Neurosurgery, University of Campinas (UNICAMP), Campinas-SP, Brazil. Electronic address: andjoaquim@yahoo.com., Yurac R; Orthopedics and Traumatology, University del Desarrollo, Clinica Alemana de Santiago, Chile., Valacco M; Sanatorio Finochietto, Hospital Churruca Visca, Buenos Aires, Argentina., Neto OR; Neurosurgery Division, Verti Spine Clinic, Caxias do Sul-RS, Brazil., Carazzo CA; Neurosurgery, University of Passo Fundo, São Vicente de Paulo Hospital, Passo Fundo-RS, Brazil., Cabrera JP; Neurosurgery, Hospital Clínico Regional de Concepción, Concepción, Chile., Teles AR; Neurosurgery Division, Verti Spine Clinic, Caxias do Sul-RS, Brazil; Neurosurgery and Spine Program, Hospital Beneficente São Carlos, Farroupilha-RS, Brazil., Sfreddo E; Neurosurgery, Hospital Cristo Redentor, Porto Alegre-RS, Brazil., Falavigna A; Neurosurgery and Spine Program, Hospital Beneficente São Carlos, Farroupilha-RS, Brazil; Verti Spine Clinic, Caxias do Sul University-RS, Caxias do Sul-RS, Brazil.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2021 Feb; Vol. 146, pp. e76-e85. Date of Electronic Publication: 2020 Oct 20.
DOI: 10.1016/j.wneu.2020.10.011
Abstrakt: Background: The treatment of unilateral CFD in patients without neurologic deficits remains controversial, especially in the choice of the best surgical approach. Our objective is to determine the way spine surgeons from Latin America manage this condition.
Methods: A survey regarding management and surgical strategies was conducted by the AO Spine Latin American Trauma Study Group considering the treatment of unilateral CFD.
Results: All AO Spine Latin American Trauma Study Group members were sent a link to the survey, among whom 285 replied, with 197 respondents answering all the questions. Nonsurgical management was considered by 25% of the surgeons. The majority stated that magnetic resonance imaging is necessary (65%) to treat this type of patient. A posterior approach was preferred by 44%, an anterior approach by 29%, and a combined approach by 25%, while 2.2% did not answer. Traction was not used by the majority of respondents (62%). In the setting of an anterior disk herniation, the majority of surgeons preferred to employ an anterior (45%) or combined (44%) approach versus an isolated posterior approach (only 0.5%). Comparing early versus late cervical trauma, fewer surgeons adopted an isolated anterior approach with the latter (29% vs. 15%).
Conclusions: Wide variations exist in the management of unilateral CFD by Latin American surgeons, with early injuries generally treated using either an anterior or posterior approach and treated early but after an MRI, while a combined approach is used more commonly with late injuries. Either an anterior or combined approach is used when disk herniation is present.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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