The timing of surgery for patients sustaining traumatic lower cervical spine injury with neurological involvement did not affect neurological recovery. Early surgical intervention was associated with a higher incidence of mortality and neurological deterioration compared with late surgical intervention, indicating that surgery after the first 72 hours might be relatively safe.

Introduction To evaluate the accurate rate of insertion and the short-term curative effect of C1, 2 pedicle screw internal fixation for atlanto-axial instability guided by surgical CT navigation. Materials and Methods Seven patients with atlanto-axial instability were treated by C1, 2 pedicle screw internal fixation and bone graft fusion, guided by surgical CT navigation, including three cases of congenital dysplasia of odontoid process, three cases of atlantoaxial instability, and one case of old odontoid process fracture. Results There was no vascular or neural injury found. The patients were followed up for 3 to 15 months. The clinical symptom was improved in some extent after operation. No looseness or breakage of screw occurred and bony fusion was achieved in all cases. Conclusion C1, 2 pedicle screw fixation is a reliable method for atlanto-axial instability. Accurate rate of insertion can be improved by surgical CT navigation. Disclosure of Interest None declared