Article

Atlantoaxial fixation using plate and screw method: a report of 160 treated patients.

Department of Neurosurgery, King Edward Memorial Hospital and Seth G.S. Medical College, Bombay, India.
Neurosurgery (impact factor: 2.79). 01/2003; 51(6):1351-6; discussion 1356-7. pp.1351-6; discussion 1356-7
Source: PubMed

ABSTRACT We review our experience with the use of the plate and screw method of fixation in the treatment of 160 patients with atlantoaxial instability during a 14-year period at our center. We previously described this method of fixation in 1994.
Between 1988 and 2001, 160 patients with atlantoaxial instability were treated with the use of a plate and screw method of fixation at the Department of Neurosurgery at King Edward Memorial Hospital in Bombay, India. The study group was composed of 91 males and 69 females (mean age, 23 yr; age range, 18 mo-79 yr). Atlantoaxial instability was a result of congenital abnormality in 132 patients (83%) and occurred after trauma in 28 patients (17%). All patients had mobile, completely reducible atlantoaxial dislocation. For 3 months postoperatively, a hard cervical collar was used. The mean follow-up period was 42 months (range, 4 mo-14 yr).
Three patients died in the postoperative phase. Successful stabilization of the atlantoaxial region was documented with dynamic radiography in the other 157 patients. There was no incidence of implant rejection. In one patient, one screw was found to be broken 18 months after surgery; however, firm bony fusion was documented in this patient. There were no neurological, vascular, or infective complications.
The plate and screw method of fixation with the use of intra-articular bone grafts in patients with atlantoaxial instability yielded a 100% fusion rate with a low incidence of complications.

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Keywords

18 months
 
28 patients
 
3 months postoperatively
 
cervical collar
 
dynamic radiography
 
firm bony fusion
 
implant rejection
 
infective complications
 
intra-articular bone grafts
 
King Edward Memorial Hospital
 
low incidence
 
mean follow-up period
 
neurological
 
patients
 
postoperative phase
 
reducible atlantoaxial dislocation
 
screw
 
screw method
 
Successful stabilization
 
trauma