ABSTRACT
Eleven patients with complex atlanto-axial instabilities were treated by occipito-cervical plating and fusion. This prospective study was done between 1997 and 2001. The indications for this operation included: 6 cases with non union fracture odontoid with dislocation of the atlanto-axial joint, 2 with old dislocation of the atlanto-axial joint, and 3 cases with pathological destruction of the body and/or the posterior elements of the second cervical vertebra [TB, metastasis, and pseudomalginant fibrous tumor]. All the patients were males. The age ranged between 18 and 49 years and the average was 35 years. All the patients had cervical cord compression symptoms and signs. All patients had skull traction before surgery for 7-10 days. Occiptocervical fusion with autogenous iliac bone graft and plating were done using a contoured small AO plate and cancellous 3.5 screws. There were no intraoperative or postoperative complications. All the patients had some neurological improvement and all showed fusion except the patient with bone secondaries who died 11 months after surgery. All the patients were satisfied with the results of surgery