[Application of C1-C2 pedicle screw fixation in atlantoaxial complex fracture].
OBJECTIVE
To explore the therapeutic effects of posterior transpedicular screw internal fixation in atlantoaxial complex fracture patients.


METHODS
Among 17 patients, there were Anderson II type of odontoid plus atlas fracture (n = 10) and Hangman plus atlas fracture (n = 7). They were categorized by their preoperative spinal cord scores according to the Frankel classification: C-class (n = 2), D-class (n = 6) and E-class (n = 5). Transpedicular screw internal fixation was performed to stabilize atlas and axis in 8 cases. Granular allograft bone was planted onto the surface of posterior arches in both atlas and axis. And the other 5 cases underwent no bony fusion.


RESULTS
All patients were followed up for an average of 24 months. All screws were successfully placed in atlas and axis. And the cases of atlantoaxial dislocation were reduced. Bony fusion was observed at Months 3 - 6 post-operation. Atlantoaxial rotational function restored satisfactorily in all patients. But axial rotation was partially lost.


CONCLUSIONS
Posterior transpedicular screw internal fixation can regain atlantoaxial joint stability immediately and promote bony fusion. And it is an effective therapy for atlantoaxial complex fracture.
Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200003, China.
Lei
L
Wang
Ji-wei
JW
Tian
Chao
C
Liu
Qing-hua
QH
Zhao
Wen
W
Yuan
D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint / Q000293:injuries* / Q000601:surgery; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult