Clinical effect of pedicle screw internal fixation system in treating atlantoaxial instability and dislocation

DENG Miao; QUAN Zheng-xue; LUO Xiao-ji; ZHANG Yuan; ZHOU Qiang; ZHOU Xu

doi:10.3969/j.issn.1009-4237.2016.01.008

Abstract：Objective To evaluate the indication,technical characteristics and clinical efficiency of the utili-zation of pedicle screw internal fixation system for atlantoaxial instability and dislocation.Methods Thirty patients with atlantoaxial instability and dislocation were treated with pedical screw internal fixation system, including 22 males and 8 females,with an average age of 43.5 years.The disease course ranged from one week to 16 years.All 30 pa-tients had inordinately cervical pain and limitation of cervical movement,moreover,22 patients had inordinately sensory and motor disorders of extremities.Four patients with congenital odontoid disconnection,eight patients with old frac-ture of odontoid process and seven patients with transverse ligament rupture were treated with auto-bone graft for fusion through posterior approach.Results There was no serious complication such as spinal cord injury,vertebral artery injury and screws broken.No wound infection was observed.X ray examination showed that the atlantoaxial anatomy structure was restored among all the patients.Neurological function had improved inordinately after 3 months postoper-atively.From X ray and CT examination,the bone fusion was achieved after 6-18 months of follow-up.There was no case with screws related complications.All the screws were in position at each follow-up.Conclusion The technol-ogy of pedical screw internal fixation system can reconstruct the atlantoaxial stability and improve the fusion rate effec-tively when used for the treatment of the atlantoaxial instability and dislocation.The low incidence of complications in-dicates that the pedical screw internal fixation system is a safe and reliable treatment method.