A comparison of effects of transoral mini plate and posterior nail plate single segment fixation in the treatment of Jefferson fractures
ZHAO Duo
LI Xiao-feng
NONG Ju-an
YANG Yuan
Abstract：Objective To analyze and compare the clinical effects of transoral mini plate and posterior nail plate single segment fixation in the treatment of Jefferson fractures. Methods A retrospective analysis was carried out on 36 patients diagnosed with unstable Jefferson fractures from April 2012 to October 2016. All patients were divided into 2 groups according to the different operation approaches: Group A ( n = 16 ), reduction and fracture fixation by transoral single segment mini plate; Group B ( n = 20 ), single segment nail plate fixation. The R-J distance ( the vertical distance from the atlas to the midpoint of the lower edge of the vertebral body base line ), VAS pain score, blood loss, operation time, complication, Frankel classification, postoperative cervical activity were compared and analyzed. 200 cases were randomly selected to measure the R-J line as the control group. Results All patients were followed up. The VAS decreased 3 months postoperatively with significant differences ( P < 0.05 ), while no significant differences between the 2 groups ( P > 0.05 ). The Frankel grade of the 2 groups returned to grade E. Six months after surgery: cervical spine ROM was almost normal with no significant differences between the 2 groups ( P > 0.05 ); bone union was achieved; no internal fixation break or loosening was observed. The R-J line showed the occipital-atlanto-axial complex recovery with significant differences before and after the surgery ( P < 0.05 ), while no significant differences between the 2 groups ( P > 0.05 ). The blood loss in Group A was significantly less than that in Group B with significant differences ( P < 0.05 ). The operation time was similar in the 2 groups with no significant differences ( P > 0.05 ). Conclusions Effects of transoral mini plate and posterior nail plate single segment fixation are good in the treatment of Jefferson fractures. Both restore the stability of the atlas, the height of occipital-atlanto-axial complex, recover the functions, and further improve the quality of life of patients. However, indications and surgical risks are different so that individualized preoperative evaluation is needed.
Keywords：Spinal fracturesCervical atlasFracture fixationinternal
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 407-412 )