Treatment of atlantoaxial dislocations among patients with cervical osseous or vascular abnormalities utilizing hybrid techniques

Journal of Neurosurgery. Spine
Shenglin WangPeter G Passias

Abstract

OBJECTIVE Most cervical fixations for atlantoaxial dislocation (AAD) are bilateral and symmetric; however, in the setting of osseous and vascular deformity at the craniovertebral junction, asymmetrical and hybrid fixations are used as "salvage" techniques. Because of the rarity of these cases, hybrid cervical fixations for AAD have not been fully explored. The aim of this study was to evaluate the clinical feasibility and outcomes of posterior hybrid cervical fixations for AAD. METHODS Twenty-one AAD cases were retrospectively studied; 18 had cervical myelopathy with Japanese Orthopaedic Association (JOA) scores ranging from 9 to 16 (mean 13.5). Hybrid fixation techniques included unilateral pedicle screws, transarticular screws, C-2 laminar screws, cervical lateral mass screws, and spinous process screws. During the same period, 82 AAD cases, treated using symmetric traditional fixations, were analyzed as controls. RESULTS Atlantoaxial fixation was performed in 11 cases, while occiput-cervical fixation was used in 10 cases. All cases achieved solid osseous fusion. Anatomical reduction was achieved in 20 cases (95.2%). All 18 cases with myelopathy showed postoperative improvement, with JOA scores ranging from 13 to 17 (mean 15....Continue Reading

References

Nov 15, 2001·Spine·J Harms, R P Melcher
Jul 21, 2004·Journal of Spinal Disorders & Techniques·Neill M Wright
May 15, 2007·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·G H TanR P Williams
Apr 9, 2008·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Arnold H Menezes
Aug 28, 2012·The Spine Journal : Official Journal of the North American Spine Society·Sang Ik ShinK Daniel Riew
Dec 18, 2013·Journal of Nanoparticle Research : an Interdisciplinary Forum for Nanoscale Science and Technology·Ruijin Wang
Aug 2, 2014·Global Spine Journal·Sun Y YangPeter G Passias
Dec 5, 2014·British Journal of Neurosurgery·Sanjiv SinhaManoj Kumar V Butte

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