Clinical Results of Harms Technique in Atlantoaxial Instability Treatment

Abstract

Objective: The aim of this study is to present the clinical experience and results in the application of atlantoaxial stabilization performed with Harms technique to contribute to the literature.Methods: Archive files of adult patients who underwent C1-2 stabilization using Harms technique with the diagnosis of atlantoaxial instability for 2015-2020 were examined. Clinical and radiological findings of 15 patients with at least 6 months of follow-up were evaluated. Preoperative clinical and radiological records, preoperative observations, postoperative complications, and clinical responses were evaluated.Results: 15 patients included in the study; 10 were men and 5 were women. The age range was 25-82 (mean: 58.7). There were 6 patients (40.0%) who had Anderson and D'Alanzo classification type 2 odontoid fracture 2 patients (13.3%) with Jefferson fracture, 2 patients (13.3%) with C2 extension type tear drop fracture, 2 patients (13.3%) with narrowing in the level of craniocervical junction, 1 patient (6.7%) with upper cervical region tumor and 2 patients (13.3%) was in the form of hangmans fracture. Screw malposition was not observed in the postoperative period. Bone fusion developed in all patients after surgery. No vertebral artery damage or neurological damage was observed. Wound infection was not observed in any of these patients. Visual analog scale (VAS) reduction and Japanese orthopedic (JOA) scores were increased in all postoperative patients.Conclusion: Surgery of atlantoaxial instability is a pathology requiring adequate surgical experience due to the complicated anatomical structure. Using the Harms technique, sufficient stability is provided with a low complication rate. With this method, improvement in the clinical findings of the patients and high bone fusion were obtained.