ABSTRACT
18 cases of atlanto-axial instability with symptoms of spinal cord compression were treated operati-vely. The reasons of instability were congenital deformity of great occipital foramen region with atlanto-axial subluxation in 7, atlantoaxial tuberculosis complicated with dislocation in 4, traumatic atlanto-axial dislocation in 5, and spontaneous dislocation of atlanto-axial joint in 2. Cranial traction was instituted preoperatively in most cases. The operations were done under local anesthesia. Open reduction of atlas, and fixation by wiring and fusion of atlanto-axial laminae with bone graft were performed in 8 cases, and occipto-cervical fusion by bone grafting with or without decompression of great occiptal foramen in 10 cases. Postoperative plaster bed or heas chest cast was stressed. All cases but one were successful, the dislocation was reduced, symptoms of spinal cord compression were relieved, the fusion was solid, and most of them returned to work.