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[Operation on upper cervical instability without injury].

Kanghua Li1, Qiang Li, Zhansheng Deng

  • 1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha Hunan, 410008, PR China. zxlq05@sina.com

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery
|June 18, 2005
PubMed
Summary

Posterior fusion techniques effectively treat upper cervical spine instability, achieving solid arthrodesis in all cases. This surgical approach led to significant neurological improvement in most patients with pre-existing nerve damage.

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Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Spinal Fusion Techniques

Context:

  • Upper cervical spine instability presents complex challenges in treatment.
  • Surgical intervention is often necessary for stability and neurological recovery.
  • Evaluating operative methods is crucial for optimizing patient outcomes.

Purpose:

  • To assess the efficacy of posterior fusion methods for treating upper cervical spine instability.
  • To analyze outcomes of atlantoaxial and occipitocervical fusions using various internal fixation devices.

Summary:

  • Twenty-three patients with upper cervical instability underwent posterior fusion using autologous bone grafts and internal fixation.
  • Techniques included atlantoaxial arthrodesis (interlaminar clamp, Atlas cable, Brooks) and occipitocervical fusion (CD-cervical, Cervifix, U-stick).

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  • Solid arthrodesis was achieved in all cases, with an average follow-up of 2.5 years. Neurological improvement was observed in 16 of 20 patients with preoperative deficits, yielding a 27.1% improvement rate by JOA standard.

    • Impact:

    • Posterior fusion demonstrates high success rates for achieving stability in upper cervical spine instability.
    • The study supports posterior fusion as a recommended treatment for upper cervical instability.
    • Outcomes suggest significant potential for neurological recovery following these surgical procedures.