RESUMO
OBJECTIVE: To explore the effect of pedicle screw instrument in treatment of irreducible atlantoaxial dislocation. PATIENTS AND METHOD: From June 2003 to February 2009, 14 cases of atlas dislocation with upper cervical cord compression were enrolled and anterior transoral soft tissue release combined with posterior reduction and pedicle screw fixation were performed. CT, MRI and radiograph were used preoperatively, and screw placement and bone graft were administered in all cases intraoperatively. Cervical collars were used for 3 months. RESULTS: Screws were successfully placed in atlas in all cases. The average follow-up period was 18 months. Bone fusion was observed in all cases without the following complications: neurologic symptoms, internal fixation failure and redislocation. Neurological recovery was observed in all 14 cases. CONCLUSIONS: Pedicle screw instrument has the following advantages in atlas and axis injury treatment: direct screw placement, short-segment fusion, intraoperative reduction and high fusion rate, which should be a better surgical method for the treatment of atlantoaxial dislocation.