Abstract
Objective To investigate the atlantoaxial release method and evaluate the effects of posterior pedicle screw rod system in the treatment of irreducible atlantoaxial dislocation. Methods Nine-teen patients with irreducible ariantoaxial dislocation were retrospectively analyzed, including 15 males, and 4 females, with the average age of 41.5 years (ranged 11 to 66 years). There were 15 patients with atlas an-terior dislocation, 4 with atlas posterior dislocation. All of patients complained of neck pain, neck activities restricted, and 14 of cases with symptoms of cervical spinal cord compression. All of patients received X-ray,MRI and CT three-dimensional reconstruction to measure translocation and rotation of atlas. According to the types and extent of irreducible atlantoaxial dislocation, anterior or/and posterior atlantoaxial release had been chosen. With continuous skull traction, the atlas was redueted and fixed with pediele screws. Fusion of at-lantoaxial had performed by lilac bone graft. Brace of head, neck and thoracic were kept for protection 12 weeks after surgeries. Results All patients were followed up 10-60 months, average 26.4 months. Com-plains of neck pain and numbness of limbs disappeared after surgery. The bone graft fused with atlantoaxial at 4.5 months in average. Translocation of atlas decreased from (8.7±2.6) mm preoperatively to (2.6±1.2) mm postoperatively. Rotation of arias deereased from (17.3°±5.8°) preoperatively to (5.0°±2.4°) postoperatively (P<0.05). No nerve or vertebral artery injuries, internal fixation failures or infections were observed. Conclu-sion The atlantoaxial release method should be chosen, according to the types and extend of atlantoaxial dislocation. A suitable release and reduction of atlantoaxial, combining with posterior pedicle screw fixation and the iliac bone fusion is an effective treatment for irreducible ariantoaxial dislocation. Key words: Atlas; Axis; Dislocation; Internal fixators
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