Four-point internal fixation technique for traumatic atlantoaxial instability / 中华创伤杂志

ABSTRACT

Objective To explore the clinical effect and application value of four-point internal fixation technique (internal fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique) for traumatic atlantoaxial instability.Methods A total of 16 patients with traumatic atlanto- axial instability,who had reducible atlantoaxial dislocation with reduction after traction and irreducible at- lantoaxial dislocation with traction reduction after anterior laxation,were treated with four-point internal fixation technique using autologous bone grafts.Results All patients' symptoms were improved to some extent,and no severe complications,such as injury of nerve blood vessels were found.All patients were followed up for 8-26 months (average 16 months).Bony fusion was obtained in all cases.The spinal cord function improvement was marked in 5 cases (31%),good in 8(50%),mild in 2(13%),but un- changed in 1 (6%).No deterioration occurred in all cases.There was no loosening or breakage of screws and clamps.Conclusion Fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique can atlain four-point internal fixation,and can provide three-dimensional stability of atlantoaxial complex and excellent biomechanics environment for bony fusion if the structure of the posterior arch of C_1-C_2 is intact.