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[Application of atlas pedicle screw system fixation and fusion for treatment of upper cervical disease]

OBJECTIVE: To explore the feasibilities, methods, outcomes and indications of atlas pedicle screw system fixation and fusion for the treatment of upper cervical diseases. METHODS: From October 2004 to January 2006, 17 patients with upper cervical diseases were treated with atlas pedicle screw system fixation and fusion. There were 13 males and 4 females, ageing 19 to 52 years. Of 17 cases, there were 14 cases of atlantoaxial dislocation (including 3 cases of congenital odontoid disconnection,4 cases of old odontoid fracture, 2 cases of new odontoid fracture (type II C), 3 cases of rupture of the transverse ligament, and 2 cases of atlas fracture; 2 cases of tumor of C2; 1 case of giant neurilemoma of C2.3 with instability after the resection of tumors. JOA score before operation was 8.3+/-3.0. RESULTS: The mean operative time and bleeding amount were 2.7 hours (2.1-3.4 hours) and 490 ml (300-750 ml) respectively. No injuries to the vertebral artery and spinal cord were observed. The medial-superior cortex of lateral mass was penetrated by 1 C1 screw approximately 3 mm without affecting occipito-atlantal motions. All patients were followed up 3-18 months. The clinical symptoms were improved in some extents and the screws were verified to be in a proper position, no breakage or loosening of screw and rob occurred. All patients achieved a solid bone fusion after 3-6 months. JOA score 3 months after operation was 14.6+/-2.2. JOA improvement rates were 73%-91% (mean 82%). CONCLUSION: The atlas pedicle screw system fixation and fusion is feasible for the treatment of upper cervical diseases and has better outcomes, wider indications if conducted properly

Keywords : Adult,Arteries,Bone Nails,Bone Screws,Bone Transplantation,Cervical Atlas,Cervical Vertebrae,China,congenital,Female,Follow-Up Studies,Fracture Fixation,Internal,Humans,injuries,instrumentation,Joint Dislocations,Joint Instability,Male,methods,Middle Aged,Motion,Patients,Rupture,Spinal Cord,Spinal Fractures,Spinal Fusion,surgery,Time,Treatment Outcome,Universities,Vertebral Artery,Young Adult,, Atlas,Pedicle,Screw,System, knee pain injections

Date of Publication : 2007 May

Authors : Li L;Wang H;Cui S;

Organisation : Department of Orthopaedics, the Second Affiliated Hospital, China Medical University, Shenyang Liaoning, 110004, P. R. China. lj-1217@163.com

Journal of Publication : Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/17578282

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