Clinical application of internal fixation technique with C2 translaminar screws for treatment of atlantoaxial instability

Abstract

Objective To investigate the clinical effect of internal fixation technique with C2 translaminar screws on atlantoaxial instability.Methods From July 2007 to October 2011,the clinical data of 26 patients with atlantoaxial instability underwent internal fixation technique with C2 translaminar screws were retrospectively analyzed.There were 21 cases of Anderson type Ⅱ and Ⅲ odontoid fractures,3 cases of congenital loose odontoid combined with atlantoaxial instability,and 2 cases of axis transverse ligament rupture.All patients had the symptoms of atlantoaxial instability or subluxation,such as craniocervical junction pain,activity limitation.Posterior vertex screw rod system was used for internal fixation.Results A total of 49 C2 translaminar screws were placed in the 26 patients.There were no complications,such as spinal cord injury or vertebral artery injury during operation.All patients were followed-up for 6-26 months,average 17 months.The clinical symptoms were improved in different degrees after operation,and all screws had good position reviewed by digital DR and CT scans.No cases of screw loosening or nail broken were observed,no obvious reset loss,all patients had bone healing at 3 to 4 months after operation.Conclusions The effect of internal fixation technique with C2 translaminar screws on atlantoaxial instability is good,and the surgical procedure is simple and safe,so it can be a supplementary method for traditional C2 internal fixation. Key words: C2 translaminar screws ; Atlas ; Axis ; Internal fixation ; Atlantoaxial instability