title: Improvement in JOA Score of Treatment for Complex Atlas-Axis fractures.
abstract: OBJECTIVE
  The aim of this study was to explore the role of treatment for complex Atlas-Axis fractures, and compare the JOA score of surgical and conservation methods.
  
  
  METHODS
  From June 2008 to May 2012, 33 patients suffering from Atlas-Axis fracture were included in our study. Fifteen patients received posterior cervical pedicle screw fixation, and 18 patients received the conservation treatment. All the patients were followed up for 12 months after discharge.
  
  
  RESULTS
  The mean operative time was about 128 minutes (ranged: 92 to 165 minutes), the mean hospital stay time was 15.5 days (ranged: 8-21 days), and the mean follow-up of all the patients was 27months (ranged: 7 to 43 months). All patients gained a solid fusion, and no one showed any disability at the end of the follow-up. The JOA scores before treatment were 6.4±0.3 and 7.1±0.4 before and after treatment, and they significantly increased to 13.8±0.8 and 13.7±0.9 when following up for 12 months (P<0.05).
  
  
  CONCLUSIONS
  Posterior cervical pedicle screw fixation is a feasible, effective and safe method for complex atlantoaxial fractures. This technique could achieve high JOA score, decreased blood loss and post-operative complications.
authors.affiliation: Yu Fu, Department of Orthopedics, Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Zhen-Ming Hu, Department of Orthopedics, Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Zhen-Ming
authors.initials: ZM
authors.lastname: Hu
authors.affiliation: Hong-jun Huo, Department of Spinal Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
authors.forename: Hong-Jun
authors.initials: HJ
authors.lastname: Huo
authors.affiliation: Xue-jun Yang, Department of Spinal Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Yang
authors.affiliation: Ting Hao, Department of Pediatric Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Hao
authors.affiliation: Wan-lin Liu, Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
authors.forename: Wan-Lin
authors.initials: WL
authors.lastname: Liu
keywords: Atlanto-axial joint; Atlas; Axis; posterior cervical pedicle screw fixation