[Repair and re-establishment to traumatic upper cervical instability].
OBJECTIVE
To summarize and analyze the therapeutic effect of traumatic upper cervical instability and investigate therapeutic methods and effect.


METHODS
There were 19 patients with traumatic upper cervical instability (male 16, female 3), aged from 21 to 56 years,included 3 cases of atlas fracture, 10 cases of dens fracture, 3 cases of axis pedicle fracture, 3 cases of atlanto-axial subluxation. Among them, 6 cases included 1 case of dens fracture, 1 case of dens fracture affiliated with atlas fracture, 1 case of axis pedicle fracture, 3 cases of atlanto-axial subluxation were treated conservatively and the other 13 cases were treated by operations.


RESULTS
Nineteen cases were followed up for 1.8 years in average (6 months to 6 years). According to JOA standard for evaluation, the rate of improvement was 42.5% and 87.0% for conservative treatment and operation respectively.


CONCLUSIONS
Traumatic super cervical unsteadiness should be diagnosed and treated early. Under the condition of upper cervical vertebra being completely fixed,the function of cervical vertebra to maximum extent could be reserved when choosing operation method. Especially, the precise fusion of upper cervical vertebra plays a vital role of long-term efficacy.
Jia
Chang-qing
CQ
Department of Spine and Joint, Hengjing Hospital, China Medical University, Shenyang 110004, Liaoning, China. jiachqzh@sina.com
Fu
Qin
Q
Liu
Zhen-ning
ZN
Han
Chang-xu
CX
Wang
Jun-feng
JF
Liang
Feng
F
Xu
Xiao-jun
XJ
D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged