Posterior occipitoaxial fusion for atlantoaxial dislocation associated with occipitalized atlas

Journal of Neurosurgery
V K JainD K Chhabra

Abstract

Between 1989 and 1994, 50 patients suffering from congenital atlantoaxial dislocation with either an assimilated atlas or a thin or deficient posterior arch of the atlas were treated with occipitocervical fusion using the technique described by Jain and colleagues in 1993 with a few modifications. An artificial bridge created from the occipital bone along the margin of the foramen magnum was fused to the axis using sublaminar wiring and interposed strut and lateral onlay bone grafts. Ten patients (20%) also underwent atlantoaxial lateral joint fusion by intraarticular instillation of bone chips. In 22 patients (44%) with irreducible dislocation, posterior fusion was preceded by transoral odontoidectomy. In seven patients (14%) with ventral compression, who showed marked clinical improvement on traction despite radiological evidence of persisting atlantoaxial dislocation, occipitocervical fusion was performed without ventral decompression. Seven patients (14%) underwent a single-stage transoral odontoidectomy and posterior fusion. There was no perioperative mortality and the osseous fusion rate was 88%. Of the 43 patients available at follow-up examination (range 3-12 months), 31 patients (72.09%) improved, seven (16.28%) remain...Continue Reading

References

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Citations

Aug 29, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Nobuhide OgiharaHiroyuki Kato
Jul 3, 2010·Journal of Neurosurgery. Spine·Corbett D WinegarAlexander R Vaccaro
Aug 23, 2011·Journal of Neurosurgery. Spine·Pravin SalunkeNiranjan K Khandelwal
Jun 5, 2012·Journal of Neurosurgery. Pediatrics·Steven W HwangAndrew Jea
Aug 11, 2007·Journal of Neurosurgery. Spine·Russ P NockelsJulie E York
Dec 14, 2007·Journal of Neurosurgery. Spine·Mandakini PradhanVijendra K Jain
Mar 13, 2012·Neurology India·Vijendra K Jain
Aug 8, 2012·Asian Journal of Neurosurgery·Haradhan Deb NathPrashant Gunawat
Mar 6, 2007·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kadir KotilTurgay Bilge
Nov 15, 2016·Neurology India·Pavaman SindgikarSanjay Behari
Dec 21, 2002·Neurosurgery·Sanjay BehariVijendra K Jain
Mar 5, 2004·The Journal of Bone and Joint Surgery. American Volume·Christian M PuttlitzJeffrey C Lotz

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Methods Mentioned

BETA
dissection
chips

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