Related Experiment Videos
[Combined atlantoaxial fractures]
J Stulík1, T Vyskocil, P Sebesta
1Spondylochirurgické oddelení FN Motol, Praha.
Summary
Combined C1-C2 fractures require individualized treatment, often favoring early surgery. Direct osteosynthesis or Harms fixation are preferred for dens fractures, aiming to preserve motion and achieve stable fusion.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Traumatology
Background:
- Combined fractures of the atlas (C1) and epistropheus (C2) represent a significant portion of cervical spine injuries.
- These injuries are diverse and require tailored therapeutic strategies.
Purpose of the Study:
- To evaluate treatment outcomes for patients with combined C1-C2 fractures.
- To propose effective therapeutic procedures for these complex injuries.
Main Methods:
- Retrospective analysis of 16 patients treated between 1996-2003 for atlantoaxial complex trauma.
- Surgical interventions included direct osteosynthesis, C1-C2 fixation (Harms, Magerl, Gallie), and occipito-cervical fixation.
- Conservative management was used in two patients; 14 underwent surgery.
Main Results:
- Fourteen surgically treated patients achieved stable C0-C1 and C1-C2 segments post-operatively.
- Complete bony union or instrumented fusion was observed within 6-24 weeks.
- Minor complications included intermittent neck pain and wound healing issues; no neurological deterioration or instrumentation failure occurred.
Conclusions:
- Early surgical intervention, particularly spondylodesis in the shortest possible segment, is recommended for combined C1-C2 fractures.
- Preserving rotational C1-C2 movement is emphasized, with options for temporary stabilization.
- An individualized approach is crucial due to the heterogeneity of these serious injuries.