Clinical advantage and outcome of modified C2 isthmus screw in three-dimensional reduction of irreducible atlantoaxial dislocation
Objective:To retrospectively analyze the advantages and clinical efficiency of modified C2 isthmus screw technique in the reduction of irreducible atlantoaxial dislocation.Methods:Totally 28 patients with irreducible atlantoaxial dislocation were treated with modified C2 isthmus screw combined with C1 pedicle/lateral mass screw for reduction and fusion.Radiological outcome was evaluated by the anterior-atlas interval(ADI),longitudinal dislocation ratio,and cervicomedullary angle(CMA).Clinical efficacy was investigated by the Japanese Orthopaedic Association(JOA)score,visual analog scale(VAS),and neck disability index(NDI)before and at the last follow-up.Results:A follow-up of 28 months(12,93 months)showed that the atlantoaxial dislocation of all patients was effectively reduced and maintained in sagittal,coronal and horizontal positions.The spinal cord compression was relieved with good bone fusion.Postoperative CT showed no screw insertion into the spinal canal or injury to the vertebral artery.The ADI,longitudinal dislocation ratio,CMA,JOA,NDI and VAS scores at the last follow-up were statistically different from preoperative ones(all P＜0.001).No complications occurred,such as intraoperative nerve injury and failure of internal fixation.Conclusions:The modified C2 isthmus screw technique is safe and can effectively complete three-dimensional reduction of atlantoaxial dislocation,especially for patients with anteroposterior,vertical,and angulated dislocation in the sagittal plane.
万方数据
维普
