Author:
Yang Kun,Niu He-gang,Tao Hui,Liu Chang,Cao Yun,Li Wei,Zhang Jing-jing,Shen Cai-liang,Zhang Yin-shun
Abstract
Abstract
Background
In the treatment of unstable atlas fractures using the combined anterior–posterior approach or the posterior monoaxial screw-rod system, factors such as severe trauma or complex surgical procedures still need to be improved despite the favourable reduction effect. This research described and evaluated a new technique for the treatment of unstable atlas fracture using a self-designed lateral mass screw-plate system.
Methods
A total of 10 patients with unstable atlas fractures using this new screw-plate system from January 2019 to December 2021 were retrospectively reviewed. All patients underwent posterior open reduction and internal fixation (ORIF) with a self-designed screw-plate system. The medical records and radiographs before and after surgery were noted. Preoperative and postoperative CT scans were used to determine the type of fracture and evaluate the reduction of fracture.
Results
All 10 patients were successfully operated with this new system, with an average follow-up of 16.7 ± 9.6 months. A total of 10 plates were placed, and all 20 screws were inserted into the atlas lateral masses. The mean operating time was 108.7 ± 20.1 min and the average estimated blood loss was 98.0 ± 41.3 ml. The lateral mass displacement (LMD) averaged 7.1 ± 1.9 mm before surgery and almost achieved satisfactory reduction after surgery. All the fractures achieved bony healing without reduction loss or implant failure. No complications (vertebral artery injury, neurologic deficit, or wound infection) occurred in these 10 patients. At the final follow-up, the anterior atlantodens interval (AADI) was 2.3 ± 0.8 mm and the visual analog scale (VAS) was 0.6 ± 0.7 on average. All patients preserved almost full range of motion of the upper cervical spine and achieved a good clinical outcome at the last follow-up.
Conclusions
Posterior osteosynthesis with this new screw-plate system can provide a new therapeutic strategy for unstable atlas fractures with simple and almost satisfactory reduction.
Funder
Natural Science Research Projects in Colleges and Universities of Anhui Province
Research Fund of Anhui Institute of translational medicine
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Rheumatology
Reference25 articles.
1. Dickman CA, Greene KA, Sonntag VK. Injuries involving the transverse atlantal ligament: classification and treatment guidelines based upon experience with 39 injuries. Neurosurgery. 1996;38(1):44–50.
2. Ryken TC, Aarabi B, Dhall SS, Gelb DE, Hurlbert RJ, Rozzelle CJ, Theodore N, Walters BC, Hadley MN. Management of isolated fractures of the atlas in adults. Neurosurgery. 2013;72(Suppl 2):127–31.
3. Lee C, Woodring JH. Unstable Jefferson variant atlas fractures: an unrecognized cervical injury. AJNR Am J Neuroradiol. 1991;12(6):1105–10.
4. Yang H, Tang T, Fei S. Unstable Jefferson variant atlas fractures: an unrecognized cervical injury. Zhonghua Wai Ke Za Zhi. 1995;33(12):707–10.
5. Kontautas E, Ambrozaitis KV, Kalesinskas RJ, Spakauskas B. Management of acute traumatic atlas fractures. J Spinal Disord Tech. 2005;18(5):402–5.
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