Posterior surgical approach for operation of atlantoaxial instability
- VernacularTitle:寰枢椎不稳的颈后路手术治疗
- Author:
Bin NI
;
Lianshun JIA
;
Jianru XIAO
- Publication Type:Journal Article
- Keywords:
Atlanto axial joint;
Joint instability;
Arthrodesis
- From:
Chinese Journal of Orthopaedics
2000;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the results of surgical treatment of atlantoaxial instability through posterior approach. Methods Seventy eight patients with atlantoaxial instability were used for this collective review, the patients included 38 with unstable odontoid fractures,15 with os odontoideum,8 with a disrupted transverse ligament, 6 with C1,2 tumor,6 with congenital occipitocervical abnormalities,5 with old Jefferson fractures. There were 57 males and 21 females. The mean age of the patients was 42 years(range, 3-78 years). All patients were treated by operation. Thirty seven patients were operated upon by atlantoaxial arthrodesis using wire fixation with autologous bone grafts. Nine were treated by C1,2 posterior wiring fixation and atlantoaxial facet screw fixation. Nine were operated on by atlantoaxial arthrodesis using Apofix interlaminar clamping with autologous bone grafts. Occipitocervical fusion was performed in 32 patients, arthrodesis simple with autologous bone grafts and external fixation was done in 11 patients. CD-Cervical fixation was used in 11 patients. Cervifix fixation was used in 10 patients. Results The patients were followed up for an average of 38.4 months(range, 6-216 months). Solid arthrodesis was obtained in 75 patients and non union in 3 cases. All the non union cases occurred after occipitocervical fusion. Conclusion Posterior fusion is recommended for atlantoaxial instability due to traumatic fracture or ligament disruption, tumor, inflammatory, skeletal dysplasias, congenital abnormalities. It is emphasized that adequately controlling atlantoaxial motion, meticulously preparing the fusion bed are the important measures for successful operation.
