Gallie technique versus atlantoaxial screw-rod constructs in the treatment of atlantoaxial sagittal instability: a retrospective study of 49 patients

Yuan, Bo; Zhou, Shengyuan; Chen, Xiongsheng; Wang, Zhiwei; Liu, Weicong; Jia, Lianshun

doi:10.1186/s13018-017-0607-y

Cited by 14 publications

(11 citation statements)

References 31 publications

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“…The longer the followup time, the better the NDI score. Similar results were found by Yuan et al [49]. This implies a kind of patients' adaptation to their disability and health state.…”

Section: Discussionsupporting

confidence: 90%

Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?

Wenning

Hoffmann

2020

J Orthop Surg Res

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Background: The C0 to C2 region is the keystone for range of motion in the upper cervical spine. Posterior procedures usually include a fusion of at least one segment. Atlantoaxial fusion (AAF) only inhibits any motion in the C1/C2 segment whereas occipitocervical fusion (OCF) additionally interferes with the C0/C1 segment. The purpose of our study was to investigate clinical outcome of patients that underwent OCF or AAF for upper cervical spine injuries. Methods: Over a 5-year period (2010-2015), consecutive patients with upper cervical spine disorders were retrospectively identified as having been treated with OCF or AAF. The Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI) were used to evaluate postoperative neck pain and health restrictions. Demographics, follow-up, and clinical outcome parameters were evaluated. Infection, hematoma, screw malpositioning, and deaths were used as complication variables. Follow-up was at least 6 months postoperatively. Results: Ninety-six patients (male = 42, female = 54) underwent stabilization of the upper cervical spine. OCF was performed in 44 patients (45.8%), and 52 patients (54.2%) were treated with AAF. Patients with OCF were diagnosed with more comorbidities (p = 0.01). Follow-up was shorter in the OCF group compared to the AAF group (6.3 months and 14.3 months; p = 0.01). No differences were found related to infection (OCF 4.5%; AAF 7.7%) and revision rate (OCF 13.6%; AAF 17.3%; p > 0.05). Regarding bother and disability, no differences were discovered utilizing the NDI score (AAF 21.4%; OCF 37.4%; p > 0.05). A reduction of disability measured by the NDI was observed with greater follow-up for all patients (p = 0.01). Conclusion: Theoretically, AAF provides greater range of motion by preserving the C0/C1 motion segment resulting in less disability. The current study did not show any significant differences regarding clinical outcome measured by the NDI compared to OCF. No differences were found regarding complication and infection rates in both groups. Both techniques provide a stable treatment with comparable clinical outcome.

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“…The longer the followup time, the better the NDI score. Similar results were found by Yuan et al [49]. This implies a kind of patients' adaptation to their disability and health state.…”

Section: Discussionsupporting

confidence: 90%

Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?

Wenning

Hoffmann

2020

J Orthop Surg Res

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“…11 Yuan et al compared the bony fusion between atlantoaxial screw-rod constructs and the Gallie wiring technique, finding good bone fusion in 100% (24/24) and 88.0% (22/25), respectively, within 3 months after surgery. 12 This recent article confirms the generally accepted opinion that screw-rod constructs provide a better fusion rate compared with screws alone in patients with atlantoaxial instability.…”

Section: Discussionsupporting

confidence: 77%

Clinical Outcome of Dorsal Cervical C1–C2 Fusion Using C1 Lateral Mass Screws, C2 Lamina Screws, and Interarcual Bone Graft Technique

Tosic

Baschera

Oberle

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Aims To evaluate the clinical and radiologic results of patients treated with dorsal cervical C1–C2 fusion using C1 lateral mass screws, C2 lamina screws, and interarcual bone graft. Methods We retrospectively analyzed the clinical and radiologic results of eight patients treated from 2011 to 2016. Neck pain, neurologic deficits, use of analgesics, vertebral artery injury, C2 root injury, radiologic fusion rate, malposition of screws, and implant failure were examined on day 3 and at 3 and 12 months postoperatively. Results One patient required revision surgery for a right-sided medial cutout of a lamina screw. None of the patients had vascular or neurologic complications. All patients were pain free and had ceased all analgesic therapy at the first follow-up examination. At the 1-year follow-up there were no complaints of neck pain, no radiologic signs of implant failure were found, and a bony union between C1 and C2 was present in all patients. Conclusion Dorsal cervical C1–C2 fusion using C1 lateral mass screws, C2 lamina screws, and interarcual bone graft are less common techniques, although they can be used safely and demonstrated excellent clinical results with regard to pain relief and a high fusion rate. The technique is an ideal alternative when other techniques are not safe for anatomical reasons.

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“…The confidence interval of the weighted mean difference (WMD) was wide and the possibility that the real WMD favors largely the group of drill guide template. We think that there are two factors contributing to the above results: the limited number of studies that we included and less intraoperative blood loss in the cervical surgery [33,34]. This study illustrated the advantages of the drill guide template, which can accurately and effectively increase the accuracy rate of pedicle screw placement and decrease the risk of postoperative complications, such as shorten the operative time and reduce intraoperative blood loss.…”

Section: Discussionmentioning

confidence: 79%

Pedicle screw placement in spinal neurosurgery using a 3D-printed drill guide template: a systematic review and meta-analysis

Xie

et al. 2020

J Orthop Surg Res

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Background: Many surgeons believe that the use of a 3D-printed drill guide template shortens operative time and reduces intraoperative blood loss compared with those of the free-hand technique. In this study, we investigated the effects of a drill guide template on the accuracy of pedicle screw placement (the screw placed completely in the pedicle), operative time, and intraoperative blood loss. Materials/Methods: We systematically searched the major databases, such as Medline via PubMed, EMBASE, Ovid, Cochrane Library, and Google Scholar, regarding the accuracy of pedicle screw placement, operative time, and intraoperative blood loss. The χ 2 test and I 2 statistic were used to examine heterogeneity. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate the accuracy rate of pedicle screw placement, and weighted mean differences (WMDs) with 95% CIs were utilized to express operative time and intraoperative blood loss. Results: This meta-analysis included 13 studies (seven randomized controlled trials and six prospective cohort studies) involving 446 patients and 3375 screws. The risk of research bias was considered moderate. Operative time (WMD = − 20.75, 95% CI − 33.20~− 8.29, P = 0.001) and intraoperative blood loss (WMD = − 106.16, 95% CI − 185.35 − 26.97, P = 0.009) in the thoracolumbar vertebrae, evaluated by a subgroup analysis, were significantly different between groups. The 3D-printed drill guide template has advantages over the free-hand technique and improves the accuracy of pedicle screw placement (OR = 2.88; 95% CI, 2.39~3.47; P = 0.000). Conclusion: The 3D-printed drill guide template can improve the accuracy rate of pedicle screw placement, shorten operative time, and reduce intraoperative blood loss.

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Gallie technique versus atlantoaxial screw-rod constructs in the treatment of atlantoaxial sagittal instability: a retrospective study of 49 patients

Cited by 14 publications

References 31 publications

Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?

Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?

Clinical Outcome of Dorsal Cervical C1–C2 Fusion Using C1 Lateral Mass Screws, C2 Lamina Screws, and Interarcual Bone Graft Technique

Pedicle screw placement in spinal neurosurgery using a 3D-printed drill guide template: a systematic review and meta-analysis

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