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[Posterior occipitocervical fixation using C2 pedicle screws and occipitocervical plate systems]
Chao Wang1, Shao-Meng Yin, Ming Yan
1Department of Orthopaedics, Peking University Third Hospital, Beijing 100083, China.
Objective:
To observe the clinical effect of a occipitocervical fixation systems using C(2) pedicle screws and plates.
Methods:
An occipitocervical fixation system was designed. Since June 2001 to March 2003, 38 patients with instability of atlantoaxial joint underwent reconstructive surgery using this systems. Twenty-four patients were associated with congenital occipitalization. The pedicle screws were inserted into C(2) pedicles in the direction as its axis. The occipitocervical plate was slightly bent to fit the occipital contour and fixed onto the occiput. Hyperflexion alignment of the occipitoatlantoaxial complex was corrected by application of extensional force created by tightening of the nut on the pedicle screws. The autogenous cancellous bones were grafted between the occiput and the axis.
Results:
In this series, neither vertebral artery nor spinal cord was injured. 36 of 38 cases were followed up for an average of 18 months, all cases achieved solid bony fusion. No implant failure was found.
Conclusions:
Occipitocervical reconstruction by the combination of C(2) pedicle screws and occipitocervical plate systems can provide sufficient correction of malalignment in the occipitoatlantoaxial region and achieve high fusion rate.