The Results of Interfacetal Fusion Using Local Bone Combined With an Atlantoaxial Instrumentation.

Abstract

Many studies have described different C1-2 fusion techniques that have evolved over time. We introduced an easy and effective C1-2 fusion technique using local bone chips combined with atlantoaxial instrumentation. To identify the efficacy of interfacetal fusion using local bone combined with atlantoaxial instrumentation by assessment of clinical outcomes and fusion rate. We retrospectively reviewed the data from 25 patients who underwent atlantoaxial stabilization surgery using C1-2 pedicle screws and interfacetal bone fusion by a single surgeon between March 2012 and December 2019. The demographics were 15 men and 10 women with a mean age of 57.6 years (range, 27-85 years) at the time of surgery. Three patients underwent surgery for myelopathy due to os odontoideum, 9 for C1-2 instability, 9 for trauma, 3 for rheumatoid arthritis, and 1 for bony spur, C1-2. At 3 months postsurgery, 3 and 21 patients showed 2-point and 1-point improvements in the Nurick grade, respectively. There was no difference in the Nurick score in 1 patient. Seven patients had a computed tomography scan at 1 year after surgery, which revealed a bridging trabecular bone. No movement was observed in the x-ray flexion/extension view at 1 year after surgery in all patients. In addition, no patients complained of postoperative occipital neuralgia. This study showed that interfacetal fusion with C1-2 pedicle screws using the free-hand technique was efficient and simple.