Ventral release and posterior screw/rod implant fusion for irreducible atlantoaxial dislocation:one-year follow-up

Sun Xiu-qin; Liao Wen-sheng; Wang Li-min; Bao Heng; Wang Wei-dong; Jian Yan-peng

doi:10.3969/j.issn.2095-4344.2014.13.013

Abstract：BACKGROUND:Transoral ventral release and posterior fusion have predominated in the treatment of irreducible atlantoaxial dislocation, but there is no consistent conclusion on the clinical efficacy. <br> OBJECTIVE:To explore the clinical outcomes of transoral ventral release and posterior fusion and screw/rod implantation in the treatment of irreducible atlantoaxial dislocation. <br> METHODS:A total of 32 patients with irreducible atlantoaxial dislocation undergoing thetransoral ventral release and posterior fusion were selected. After treatment, they received cervical anteroposterior and lateral digital DR and cervical MRI examinations to understand the conditions of nerve compression and bone fusion. The recovery of nerve function was evaluated using Japanese Orthopaedic Association before treatment, 6 months after treatment and during final fol ow-up. <br> RESULTS AND CONCLUSION:Post-treatment, 29 patients were fol owed-up for an average period of 12 months. (1) Al the patients obtained perfect atlantoaxial joint reduction and bone fusion. This achieved reduction and reconstruction of spinal column stability. (2) Spinal compression was obviously lessened after treatment in al patients, and nerve functions were improved to different degrees. Significant differences in Japanese Orthopaedic Association score were detected between 6 months post-treatment, final fol ow-up and pre-treatment (P<0.05). (3) There were no serious intraoperative complications such as spinal cord or vertebral artery injuries. Postoperative complications such as infection or burst were also not found. (4) Imaging evaluation revealed that transoral ventral release and posterior fusion is safe and effective for treatment of irreducible atlantoaxial dislocation.