[Treatment of combination atlantoaxial fractures with posterior fusion plus atlantoaxial pedicle screw].

ABSTRACT

OBJECTIVE: To explore the clinical feasibility, approach, efficacy and indications of posterior fusion plus pedicle screw fixation in the treatment of combination atlantoaxial fractures. METHODS: A retrospective analysis was conducted for 26 cases of Jefferson and dens fracture treated with atlantoaxial pedicle screw from June 2008 to May 2010. RESULTS: The postoperative radiographs verified an excellent position of all screws with a satisfactory atlantoaxial reduction. Operative time was (126 ± 26) min, and blood loss was (350 ± 107) ml. During an average follow-up period of 14 months (range 6 - 28), it showed no spine cord and vertebral artery injury or interfixation failure. Atlantoaxial alignment and stability were restored without any instrumentation-related complication. CONCLUSION: Posterior atlantoaxial pedicle screw and rod fixation may provide immediate three-dimensional rigid fixation of atlantoaxial joint. This technique is more effective than other previously reported approaches.