Abstract
Objective To explore the surgical feasibility and clinical outcome of C1 lateral mass-C2 pars articular screw fixation (Goel's method) in the treatment of atlantoaxial dislocation combined with C1 assimilation.Methods 138 patients were diagnosed basilar impression with atlantoaxial dislocation and C1 assimilation.All of the patients underwent the posterior operation of open reduction and arthrodesis with C1,2 joint fixations with rods,and screws in the lateral masses and pars articulars of the atlas and axis.Results Complete reduction was achieved in 54 cases,83 patients obtained partial reduction,87 patients were followed up more than 3 months,85 cases achieved solid fixation and arthrodesis,and 2 cases appeared internal instruments loosened and underwent revised surgery.According to Odom's scoring system,among the 87 patients with preoperative upper cervical myelopathy,35 patients were assessed as excellent,50 good,2 fair,and 0 poor.One patient exploded respiration and cardiac arrest at 12 hours post operation.Conclusions Posterior reduction and arthrodeses with rigid internal fixators by the Goel method could achieve satisfactory outcomes in patients with atlantoaxial dislocation. Key words: Internal fixators; Atlas; Occipitalization; Atlanto-axial dislocations; Goel method
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