Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-09-2015 | Orthopaedic Surgery

The efficacy of pedicle screw instrument in treatment of irreducible atlantoaxial dislocation

Authors: Ming-yu Zhai, Chun-ping Wang, Feng Liu, Yu-qiang Liu, Peng Zhang

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2015

Abstract

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.

Tan M, Wang H, Wang Y, Zhang G, Yi P, Li Z, Wei H, Yang F (2003) Morphometric evaluation of screw fixation in atlas via posterior arch and lateral mass. Spine (Phila Pa 1976) 28(9):888–895. doi:10.1097/01.BRS.0000058719.48596.CC

Guo X, Ni B, Xie N, Lu X, Guo Q, Lu M (2014) Bilateral C1–C2 transarticular screw and C1 laminar hook fixation and bone graft fusion for reducible atlantoaxial dislocation: a seven-year analysis of outcome. PLoS One 9(1):e87676. doi:10.1371/journal.pone.0087676 PubMedCentralCrossRefPubMed

Chowdhury FH, Haque MR (2014) C1–C3 lateral mass screw-rod fixation and fusion for C2 pathologies and Hangman’s fractures. Asian Spine J 8(6):735–746. doi:10.4184/asj.2014.8.6.735 PubMedCentralCrossRefPubMed

Kim HS, Suk KS, Moon SH, Lee HM, Kang KC, Lee SH, Kim JS (2015) Safety evaluation of freehand lateral mass screw fixation in the subaxial cervical spine: evaluation of 1256 screws. Spine (Phila Pa 1976) 40(1):2–5. doi:10.1097/BRS.0000000000000667

Dahdaleh NS, Dlouhy BJ, Menezes AH (2013) One-step fixation of atlantoaxial rotatory subluxation: technical note and report of three cases. World Neurosurg 80(6):e391–e395. doi:10.1016/j.wneu.2012.11.040 CrossRefPubMed

Ma X, Yin Q, Xia H, Wu Z, Yang J, Liu J, Xu J, Qiu F (2015) The application of atlantoaxial screw and rod fixation in revision operations for postoperative re-dislocation in children. Arch Orthop Trauma Surg. doi:10.1007/s00402-014-2150-1 PubMedCentral

Meng XZ, Xu JX (2011) The options of C2 fixation for os odontoideum: a radiographic study for the C2 pedicle and lamina anatomy. Eur Spine J 20(11):1921–1927. doi:10.1007/s00586-011-1893-4 PubMedCentralCrossRefPubMed

He BR, Hao DJ, Zhou JS, Liu TJ, Wu Q, Guo H, Wang XD (2005) Treatment of atlantoaxial instability by using lateral mass screw of atlas combined with vertebra dentata pedic le screw. Chin J Trauma 21(10):4

Pissonnier ML, Lazennec JY, Renoux J, Rousseau MA (2013) Trauma of the upper cervical spine: focus on vertical atlantoaxial dislocation. Eur Spine J 22(10):2167–2175. doi:10.1007/s00586-013-2841-2 PubMedCentralCrossRefPubMed

10.

Wang J, Xia H, Ying Q, Lu Y, Wu Z, Ai F, Ma X (2013) An anatomic consideration of C2 vertebrae artery groove variation for individual screw implantation in axis. Eur Spine J 22(7):1547–1552. doi:10.1007/s00586-013-2779-4 PubMedCentralCrossRefPubMed

11.

Xu J, Yin Q, Xia H, Wu Z, Ma X, Zhang K, Wang Z, Yang J, Ai F, Wang J, Liu J, Mai X (2013) New clinical classification system for atlantoaxial dislocation. Orthopedics 36(1):e95–100. doi:10.3928/01477447-20121217-25 CrossRefPubMed

12.

Resnick DK, Benzel EC (2002) C1–C2 pedicle screw fixation with rigid cantilever beam construct: case report and technical note. Neurosurgery 50(2):426–428PubMed

13.

Ishikawa M, Cao K, Pang L, Watanabe K, Yagi M, Hosogane N, Machida M, Shiono Y, Nishiyama M, Fukui Y, Matsumoto M (2015) Postoperative behavior of thoracolumbar/lumbar curve and coronal balance after posterior thoracic fusion for Lenke 1C and 2C adolescent idiopathic scoliosis. J Orthop Sci 20(1):31–37. doi:10.1007/s00776-014-0655-7 CrossRefPubMed

14.

Mandel IM, Kambach BJ, Petersilge CA, Johnstone B, Yoo JU (2000) Morphologic considerations of C2 isthmus dimensions for the placement of transarticular screws. Spine (Phila Pa 1976) 25(12):1542–1547

15.

Ebraheim N, Rollins JR Jr, Xu R, Jackson WT (1996) Anatomic consideration of C2 pedicle screw placement. Spine (Phila Pa 1976) 21(6):691–695CrossRef

16.

Yin YH, Qiao GY, Yu XG, Tong HY, Zhang YZ (2013) Posterior realignment of irreducible atlantoaxial dislocation with C1–C2 screw and rod system: a technique of direct reduction and fixation. Spine J 13(12):1864–1871. doi:10.1016/j.spinee.2013.08.014 CrossRefPubMed

17.

Ma XY, Zhong SZ, Liu JF, Yin QS, Xu DC, Peng CH (2003) Anatomic study of the atlas pedicle screw entry point. J Bone Jt Inj 18 (10):3. doi:10.3969/j.issn.1672-9935.2003.10.014

18.

Huang DG, Hao DJ, Li GL, Guo H, Zhang YC, He BR (2014) C2 nerve dysfunction associated with C1 lateral mass screw fixation. Orthop Surg 6(4):269–273. doi:10.1111/os.12136 CrossRefPubMed

Title: The efficacy of pedicle screw instrument in treatment of irreducible atlantoaxial dislocation
Authors: Ming-yu Zhai
Chun-ping Wang
Feng Liu
Yu-qiang Liu
Peng Zhang
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 9/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2261-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The efficacy of pedicle screw instrument in treatment of irreducible atlantoaxial dislocation

Abstract

Objective

Patients and method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Patients and method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2015

Rotational alignment of tibial components in mobile-bearing TKA: posterior substituted vs. PCL retaining

Incidence and risk factors for heterotopic ossification after total hip arthroplasty: a meta-analysis

Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study

The compliance with and knowledge about radiation protection in operating room personnel: a cross-sectional study with a questionnaire

Outcome of transtrochanteric rotational osteotomy for posttraumatic osteonecrosis of the femoral head with a mean follow-up of 12.3 years

Abstracts