Variations in surgical treatment of cervical facet dislocations.
Publication/Presentation Date
4-1-2008
Abstract
STUDY DESIGN: Retrospective Survey Analysis.
OBJECTIVE: To explore surgeon preference in the choice of surgical approach in the treatment of traumatic cervical facet dislocations.
SUMMARY OF BACKGROUND DATA: The choice of surgical approach in the treatment of traumatic cervical dislocations is highly variable and maybe influenced by a variety of factors. The purpose of this study was to examine inter-rater reliability in choice of surgical approach.
METHODS: Twenty-five members of the Spine Trauma Study Group evaluated 10 cases of traumatic cervical dislocations. Evaluation of the case as a unilateral or bilateral injury and surgeon interpretation of the presence of a disc herniation as well as preferred surgical approach were assessed.
RESULTS: Only slight agreement was observed among surgeons in the choice of surgical approach (Kappa < 0.1). This improved slightly when patients were assumed to have a complete spinal cord injury (Kappa = 0.15). Surgeons used more anterior approaches either alone or as the first stage in a combined approach when a disc herniation was present regardless of neurologic status of the patient. When a patient was neurologically intact, an anterior approach was more common than a posterior approach even when a disc herniation was not present. Combined approaches were preferred for the treatment of bilateral facet dislocations.
CONCLUSION: The poor agreement on the treatment of these injuries likely reflects a combination of factors including surgeon training and experience. Treatment decisions are likely to be affected by the neurologic status of the patient, interpretation of a disc herniation, and the classification of the injury as a unilateral or bilateral injury.
Volume
33
Issue
7
First Page
188
Last Page
193
ISSN
1528-1159
Published In/Presented At
Nassr, A., Lee, J. Y., Dvorak, M. F., Harrop, J. S., Dailey, A. T., Shaffrey, C. I., Arnold, P. M., Brodke, D. S., Rampersaud, R., Grauer, J. N., Winegar, C., & Vaccaro, A. R. (2008). Variations in surgical treatment of cervical facet dislocations. Spine, 33(7), E188–E193. https://doi.org/10.1097/BRS.0b013e3181696118
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
18379387
Department(s)
Administration and Leadership
Document Type
Article