Results of 14 Cervical Luxations or Subluxations Stabilized with Posterior Louis’ Plates

Abstract

Between July 1986 and December 1987 11 men and 3 women aged 15 to 69 years (mean 34.7) were operated for a cervical spine luxation or subluxation, more often at C5–C6 levels (7 cases) than C6–C7 and C4–C5. Seven patients were injured from vehicle accidents, 3 in sports accidents (skiing or diving), 2 fell from a tree, 1 fell down the stairs and 1 had an undetermined accident (alcoholism). Three became quadriplegic, 4 presented with motor root lesions and 1 had a medullary contusion. According to the classification of Harris [1], 8 patients presented with a flexion injury (3 bilateral interfacetal dislocations, 2 anterior subluxations, 2 tear-drop fractures and 1 a compression fracture). Six flexion-rotation injuries resulted in unilateral luxations or subluxations. Only 3 were pure ligamentous injuries, the others showed a ligamentous and simultaneous bony lesion (Table 1) discovered during the operation or on radiographs. Twelve lesions were seen on standard radiographs and 2 on functional radiographs. Six sagittal tomograms and 6 axial computed tomograms showed associated fractures but provided little useful information for the operative indication. When the bony lesions did not explain the neurologic lesions, we utilized myelography. It was done for 3 patients and showed no herniated disk. A magnetic resonance performed for a facet fracture with subluxation also did not bring additional information.