title: [Comprehensive typing and surgical treatment of axial fracture with adjacent section instability: analysis of 17 cases].
abstract: OBJECTIVE
  To study the clinical and radiographic characteristics of axial fracture with adjacent section instability and the diagnosis and surgical treatment thereof.
  
  
  METHODS
  Seventeen patients of axial fracture with adjacent section instability, 11 males and 7 females, aged 34 (23-56) underwent different treatment patterns depending on the fracture type and stability of the atlanto-axial joint and C2-3: resection of C2-3 intervertebral disk and bone grafting, anterior interbody fusion and plate internal fixation, odontoid screw fixation, posterior C2 pedicle screw fixation, odontoid screw fixation combined with bilateral C-2 pedicle screw fixation. Follow-up was conducted for 12 (6-36) months.
  
  
  RESULTS
  Postoperatively all patients were immobilized in a hard collar for 3 months. Bony fusion was obtained in all patients in 3 months. There were no operation-related complications, such as spinal cord injury, cerebrospinal fluid leakage, vertebral artery injury, etc. No re-dislocation was found. Neurological recovery was observed in the 3 patients who presented neurological deficits.
  
  
  CONCLUSIONS
  The type of atlas fracture with adjacent section instability and the impact thereof on the stability of the atlanto-axial joint and C2/3 neck joint should be identified early. Surgical treatment results in better outcome.
authors.affiliation: Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Ji-wei
authors.initials: JW
authors.lastname: Tian
authors.forename: Qing-hua
authors.initials: QH
authors.lastname: Zhao
authors.forename: Shuang-hai
authors.initials: SH
authors.lastname: Dong
authors.forename: Tian
authors.initials: T
authors.lastname: Xia
mesh_terms: D000328:Adult; D001368:Axis, Cervical Vertebra / Q000293:injuries; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D055815:Young Adult