Background: Traumatic cervical subluxation is a significant cause of neurological deficits, often requiring surgical intervention. This study evaluates the neurological improvement and functional outcomes in patients with traumatic cervical subluxation treated with anterior cervical discectomy and fusion (ACDF).

Methods: A prospective single-center study was conducted at Government Vellore Medical College Hospital, including 36 patients aged over 18 years with traumatic cervical subluxation confirmed by MRI and treated with ACDF. Exclusion criteria included active cervical infection, neoplasia, metastasis, failed previous cervical surgery, or neurovascular injury. Demographic data, preoperative and postoperative neurological status (ASIA scale), radiographic findings, and functional outcomes (Nurick grades) were analyzed over a 6-month follow-up.

Results: Of the 36 patients, 80.6% showed functional improvement: 16.7% achieved a cure (Nurick grade 0 or 1), 36.1% had good outcomes (two-grade improvement), 27.8% had fair outcomes (one-grade improvement), and 19.4% had poor outcomes (no change). ASIA scale improvement occurred in 34.5% of patients, with ASIA A injuries showing the least recovery (28.6%). The 30-day mortality rate was 8.6%, primarily due to respiratory failure in ASIA A patients.

Conclusion: ACDF significantly improved functional outcomes in patients with traumatic cervical subluxation, particularly those without respiratory distress or comorbidities. Early surgical intervention is recommended for poor-grade cases