Efficacy of occipitocervical fusion with Halo frame surgical treatment for atlantoaxial dislocation

Abstract

Objective To investigate the effect of occipitocervical fusion with Halo frame surgical treatment for atlantoaxial dislocation.Methods From January 2008 to January 2012,65 patients(37 males and 28 females) ;with aged 17-64 year old,mean 40.6 year old;suffering from craniocervical malformation were reviewed.All patients had atlantoaxial dislocation,39 patients had basilar invagination,28 patients had occipital-atlas fusion,19 patients had Arnold-chiari' s malformation,17 patients had syringomyelia.The preoperative JOA score were 5-10 points,mean score were (7.3 ± 1.7) points.All patients had the surgical treatment of occipitocervical fusion under fixation of Halo frame,and the integral imaging data and clinical data.Preoperative and follow-up JOA scores were utilized.Results All patients underwent the occipitocervical fusion under fixation of Halo frame successfully without any neurological deficit or vascular injury.The average operative time were 150-200 minutes,mean time were 165minutes ;blood loss were 150-330 ml,an average of 220 ml,no blood vessels,spinal cord injury or other severe complications occured.JOA score of the first day after operation were 7-14 points,mean score were(10.0 ± 2.0)points,which showed signifcant improvement compared with before operation (P ＜0.05).X-ray,MRI and CT after operation showed complete reduction in all patients.The follow-up were 6-48 months,with an average time of 22.5 months.At the last follow-up,JOA score were 11-16 points,mean score were (14.2 ± 1.5) points,which improved significantly than before operation and one day after operation (P ＜ 0.05).During the follow-up,one patient died of cerebral infarction postoperatively,other patients found no implant loosening,fracture,and bone healing was obtained within 3 to 6 months after surgery.Conclusions The occipitocervical fusion with Halo frame surgical treatment for atlantoaxial dislocation is effective,reliable and safe for short-term outcome. Key words: Atlantoaxial dislocation; Halo frame; Occipitocervical fusion