Occipitocervical fusion for post-traumatic upper cervical spine instability

ABSTRACT

This study included fourteen patients presented with acute post- traumatic upper cervical spine instability. Out of the fourteen patients, eleven had atlantoaxial instability, two had fracture odontoid and one had craniocervical instability. They underwent occipitocervical fusion using iliac bone graft from occiput to second cervical vertebra. The iliac bone graft was augmented by wiring in nine patients. At follow up [average 12 months], 13 patients had a solid fusion and relief of neck pain. Out of the four patients who were unable to walk preoperatively because of severe motor involvement, only one was considered to be able to walk. Out of the fourteen patients, eleven had a satisfactory result. Occipitocervical fusion using iliac bone graft and the wiring technique provides immediate stable fixation allowing early mobilization. It is recommended in patients who had instability of the upper cervical spine. The operation may optimize the patient's chances of neurological recovery