Abstract：Objective To explore the surgical strategies for patients of lower cervical spinefracture complicated with zygapophyseal joints dislocation.Methods We retrospectively analyzed 47 cases of lower cervical spine fracture complicated with zygapophyseal joints dislocation，including 35 cases of males and 12 cases of females，from January，2008 to August，2016.Mean ageof the patientswas (42.2±10.8)years (range，22～65 years).Among them，19 cases underwent simple anterior decompression and internal fixation and bone graft fusion after closed reduction，and the remaining 28 cases were treated with single posterior open reduction decompression internal fixation and bone graft fusion second to the failure of closed reduction.American Spinal Injury Association (ASIA) Grade of neurologic function was used for evaluation of therapeutic effect.Results Mean of follow-up was (21.6±8.6)months (range，12～47 months).The operation time and amount of bleeding were (97.8±7.1)min and (127.5±15.8)mL，respectively，in the group of simple anterior decompression and internalfixation and bone graft fusion.And the operation time and amount of blood loss were (127.2±8.6)min and (412.5±19.5)mL，separately，in the group ofsingle posterior open reduction decompression internal fixation and bone graft fusion.All facet dislocations achieved satisfactoryreduction after surgery.And ASIA grade in both of the two groups were significantly improved aftersurgery (P＜0.05).Mean of bone grafting fusion time (5.8±1.6)months (range，4～9 months).There was no instrumentation looseness，fracture and displacement during the follow-up.Conclusion For the patients of lower cervical spine fracture complicated with zygapophyseal joints dislocation，once obtained closed reduction，simple anterior decompression and internal fixation and bone graft fusion is enough for decompression and stability reconstruction；once failed for closed reduction，single posterior open reduction decompression fixation and fusion is more suitable to achieve zygapophyseal joints dislocation reduction，and the recovery of neurological deficit is very satisfying due to effective spinal canal decompression.
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