Atlantoaxial joint jamming as a treatment for atlantoaxial dislocation: a preliminary report

Abstract

In this report the author describes an alternative technique of atlantoaxial fixation that involves blocking or "jamming" of movements of the atlantoaxial joint. The technique involves forcible impaction of spiked titanium metal spacers and bone grafts within the distracted atlantoaxial facet joints. Between January 2003 and January 2006, four patients underwent this method of fixation at the Department of Neurosurgery at King Edward Memorial Hospital in Mumbai, India. All four patients had posttraumatic mobile and reducible atlantoaxial dislocation. The mean follow-up period was 16 months (range 5-35 months). Successful atlantoaxial stabilization along with ultimate bone fusion was achieved in all patients and was documented on dynamic radiographs. There were no neurological, vascular, or infection-associated complications. The author concludes that the described method of atlantoaxial fixation provides an alternative treatment strategy. "Joint jamming" as a stand-alone method or in combination with other fixation methods may provide firm stabilization in cases of atlantoaxial dislocation.