title: Surgical treatment of complex axis fractures with adjacent segment instability.
abstract: This study investigates the clinical and radiographic characteristics of complex axis fractures with adjacent segment instability and describes the outcome of surgical treatment. Twenty-one patients (14 male, seven female; mean age=34 years) with complex axis fractures and adjacent segment instability who were treated between August 2003 and June 2009 were retrospectively reviewed. Treatment selection was based on fracture type and stability of the upper cervical segments. All patients were immobilized with a hard collar for three months after surgery. The mean follow-up period was 12 months (range=6-36 months). No intraoperative surgery-related complications were observed and fusion was achieved in all patients. The outcome was excellent for 17 patients, good for two patients, fair for one patient, and poor for one patient. The upper cervical segments that can become unstable due to complex axis fractures include the atlantoaxial and C2-3 joints. Recommended surgical treatments produce good results.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai First People's Hospital, Shanghai Jiaotong University, 100 Haining Road, Shanghai 200080, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Tian
authors.initials: T
authors.lastname: Xia
authors.forename: Shuanghai
authors.initials: S
authors.lastname: Dong
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Zhao
authors.forename: Jiwei
authors.initials: J
authors.lastname: Tian
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D001268:Atlanto-Axial Joint / Q000293:injuries; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000293:injuries*; D002574:Cervical Vertebrae / Q000293:injuries; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult