Clinical observation of C1-2 pedicle screw ifxation for the disruption of the transverse atlantal ligament

MA Hao-ning; TAN Ming-sheng; YI Ping; YANG Feng; TANG Xiang-sheng; HAO Qing-ying

doi:10.3969/j.issn.2095-252X.2015.08.003

Abstract：Objective To investigate clinical effects of posterior C1-2 pedicle screw ifxation for the disruption of transverse atlantal ligaments.Methods From September 2002 to June 2014, 28 cases of the disruption of transverse atlantal ligaments undergoing C1-2 pedicle screw fixation were reviewed retrospectively. There were 17 males and 11 females with the age ranging from 4 to 56 years ( mean: 31.8 years ). 6 cases were of acute injuries while the other 22 cases were old injuries. 23 cases were combined with neurological deficits. X-ray films demonstrated that the atlanto-dental intervals ( ADI ) was 5-12 mm. According to TOI ( traction reduction type, T; operation reduction, O;irreducible type, I ) classiifcation, there were 24 cases of T2 and 4 cases of O. Cases of T2 underwent posterior C1-2 pedicle screw ifxation and fusion while cases of O underwent anterior tissue release together with posterior internal ifxation and fusion. The space available for the cord ( SAC ), Japanese Orthopaedic Association ( JOA ) score, and neck disability index ( NDI ) before surgery were compared with those in the last follow-up.Results All the cases were followed up from 8 to 92 months ( on an average of 34.5 months ). The JOA score was ( 12.35±3.46 ), SAC in atlas level was ( 9.84±2.32 ) mm and NDI was ( 38.34±10.23 ) preoperatively while in the last follow-up the JOA score was ( 14.28±1.53 ), SAC in atlas level was ( 14.73±1.84 ) mm and NDI score was ( 18.24±7.13 ), which were improved signiifcantly with statistical signiifcance (P<0.05 ).Conclusions Posterior C1-2 pedicle screw ifxation is reliable for atlantoaxial dislocation caused by the disruption of transverse atlantal ligament.