Design and preliminary clinical application of specified posterior atlantoaxial screw rod fixation instruments

MA Xiangyang; YANG Jincheng; ZOU Xiaobao; CHEN Shujin; YANG Min; WANG Binbin; QIU Feng; XIA Hong; YIN Qingshui

doi:10.3969/j.issn.1674-666X.2016.05.001

Abstract：Objective To design screw rod internal fixation instruments specially used for posterior atlantoaxial surgery, and to observe its preliminary clinical applications. Methods In view of the shortcomings of current posterior cervical screw rod fixation system for atlantoaxial dislocation during the clinical practice, a set of new specified posterior atlantoaxial screw rod fixation system was designed, including C1 reduction screw, C2 fulcrum screw, automatic anti-rotation fixation rod, transverse-link of screw tail as well as other matched installation instruments such as cone-shaped screw tap. Six patients performed posterior atlantoaxial screw rod fixation with this new-type system under intratracheal general anesthesia, and the applications were observed. Results All 6 patients underwent the operations successfully, including 3 cases of fixation without bone graft fusion and 3 of fixation with bone graft fusion. The average operative time was 95 min (60-150 min), and the average intraoperative estimate blood loss was 50 mL (30-80 mL). No spinal cord or vertebral artery injuries were found during the operation. Screw, fixation rod and transverse-link of this new fixation system were installed in place at one go, with no repeated adjustments or assistance by additional tools. Postoperative X-ray, CT and MRI results showed a satisfied reduction and decompression. Conclusion The specified posterior atlantoaxial screw rod fixation system is a novel and creative device, not only simplify the operation procedure, but also has a satisfactory preliminary clinical effects and excellent application prospect.