~ 396 ~ International Journal of Orthopaedics Sciences 2022; 8(1): 396-399 E-ISSN: 2395-1958 P-ISSN: 2706-6630 IJOS 2022; 8(1): 396-399 © 2022 IJOS www.orthopaper.com Received: 09-11-2021 Accepted: 11-12-2021 Shagor Kumar Sarker Assistant Professor, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh Syed Shahidul Islam Professor, Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh Chowdhury Iqbal Mahmud Associate Professor, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka 1000, Bangladesh Md. Anowarul Islam Professor, Spinal Surgery Unit, Department of Orthopaedic Surgery, BSMMU, Dhaka, Bangladesh. Md. Mahmudur Rahman Assistant Professor, Department of Orthopaedic Surgery, Ad-Din Medical College, Dhaka, Bangladesh Sajeeb Imtiazur Rahman Resident, Department of Orthopaedic Surgery, NITOR, Dhaka, Bangladesh Corresponding Author: Shagor Kumar Sarker Assistant Professor, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh Anterior Cervical Discectomy and Fusion (ACDF) with Stabilization by cervical locking plate and screw in traumatic sub-axial incomplete cervical spine injury: Early experience Shagor Kumar Sarker, Syed Shahidul Islam, Chowdhury Iqbal Mahmud, Md. Anowarul Islam, Md. Mahmudur Rahman and Sajeeb Imtiazur Rahman DOI: https://doi.org/10.22271/ortho.2022.v8.i1f.3046 Abstract Introduction: Cervical spine injuries represent 2 to 6% of adult blunt trauma, and one third of all spinal injuries. Anterior approach of operative management of cervical spinal injury with incomplete neurological lesion has least analyzed in our settings, the present study has been designed to evaluate the outcome of ACDF and stabilization by cervical plate and screw for managing traumatic cervical spine injury with incomplete neurological deficit. Methods: This study was conducted at NITOR, Dhaka, from July 2016 to June 2018.Twenty available patients meeting the inclusion & exclusion criteria were included. All cases were properly evaluated pre- operatively and underwent ACDF & stabilization with cervical plate and screws. Follow up was done for 5 to 12 months. The final assessment was done by ASIA impairment scale, MRC grading, Bridewell fusion grade, Denis work & pain scale and modified Odom’s criteria. Results: Highest number of patients 10 (50%) were in ASIA grade B, 7(35.0%) patients were in ASIA grade D and 3(15.0%) patients were in ASIA grade C on admission. But in last follow up, highest number of patients were in ASIA grade E (45%). The ASIA grade has improved 1 grade in 55% cases. Bridewell fusion grade showed anterior fusion grade I in 55% of cases, grade II in 45% cases. 60% of cases were in W2 group of Denis work scale after last follow up. Early post-operative complications were dysphagia (20%), respiratory distress (5%) and neck pain (20%). Late post-operative complications were neck pain (10%), donor site pain (5%) and bed sore (5%). According to modified Odom’s criteria, 65% of the cases were found excellent. Conclusion: On the basis of the results in this study, it can be said that anterior cervical decompression, stabilization and fusion by bone graft of the patients who have traumatic unstable cervical spine injury with incomplete neurological lesion will provide effective benefit. Keywords: Cervical spine injury, incomplete neurological deficit, ACDF Introduction The cervical spine is functionally the most important region of the spine. But it is difficult to assess because of its complex anatomy, biomechanics and the complex mechanism of injury of spinal trauma. So careful assessment of the region is vital as any error will have devastating consequences for the patients. Cervical spinal injury occurs most frequently in the young male patient with an average age of 35 years [1] . Cervical spinal cord injury may be complete, resulting in quadriplegia and incomplete resulting in anterior cord syndrome, central cord syndrome, Brown-Sequard syndrome, and specific nerve root injury. Approximately 40% of cervical spinal cord injury patients presents with complete spinal cord injuries and 20% with either no cord or only root lesions [2] . Cervical spine dislocation is not an uncommon phenomenon. It carries a double threat as it also damage neural tissues as well. Unilateral facet dislocation usually results from flexion and rotation of the cervical spine. The most common site is C5-6. Patient may present with an isolated nerve root injury or an incomplete neurological deficit. The injury may be purely ligamentous causing dislocation. In less than 50% of patients, closed reduction is not successful [3] . Those who sustain a complete spinal cord injury are unlikely to regain functions below the level of injury. Incomplete injuries usually show some degree of improvement over time, but in most of the cases improvement is