Atlanto-axial pedicle screw plate and fusion in treatment of upper cervical injuries / 中国矫形外科杂志

ABSTRACT

[Objective]To investigate the effect of atlanto-axial pedicle screw plate and fusion in treatment of upper cervical injuries. [Methods]Fifty-six cases of upper cervical spine injuries were treated with atlanto-axial pedicle screw plate and internal fixation,with total 200 screws,from March 2000 to September 2007.There were 36 males and 14 females,with an average age of 41.52 years(ranged,20~65 years).There were 23 cases of type II odontoid process fracture,12 cases of odontoid process nonunion,15 cases of transverse ligament injury.[Results]Greater occipital nerve pain occurred in 4 cases postoperatively and fully recovered after treatment 1 month later.The lateral cortical bone was penetrated by screws in 2 cases,without spinal cord or vertebral artery injury.Forty-eight cases were followed up for an average of 27.56 months(ranged,25~60 months).Bone fusion was achieved in all cases,without plate or screw broken.X-ray showed complete replacement of atlas and odontoid process of axis fracture.CT showed good position relation between screw and vertebral artery or spinal cord.According to JOA classification,excellent result was achieved in 34 cases,good in 13 cases,fair in 2 cases,poor in 1 case,with the good-to-excellent rate of 94.00%.[Conclusion]Atlanto-axial pedicle screw combined with plate fixation system is effective in treatment of upper cervical injuries.It can significantly improve the biomechanical stability of atlantoaxial joint,with high bone graft fusion rate.