Transoral atlantoaxial reduction plate internal fixation for the treatment of irreducible atlantoaxial dislocation: a 2- to 4-year follow-up

Yin, Qudong; Ai, Fuzhi; Zhang, Kai; Mai, Xiao-Hong; Xia, Hong; Wu, Zenghui

doi:10.1111/j.1757-7861.2010.00077.x

Cited by 44 publications

(46 citation statements)

References 5 publications

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“…For AAS without good reduction with the utility of skull traction under general anesthesia, sufficient release of the dislocated atlantoaxial joint is of key importance for successful treatment. In order to achieve good reduction, various methods had been used for IAAD patients, including transoral odontoidectomy and posterior fixation [15], transoral atlantoaxial reduction plate internal fixation [16,17], transoral atlantoaxial release and posterior internal fixation [18,19], and anterior submandibular retropharyngeal approach and posterior internal fixation [20]. All these procedures had advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of atlantoaxial subluxation by intraoperative skull traction and C1-C2 fixation

Guo

et al. 2020

BMC Musculoskelet Disord

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Background: Atlantoaxial subluxation (AAS) is a not rare abnormality between the atlas (C1) and axis (C2). For AAS patients with persistent neck pain and neurologic symptoms, surgical intervention is a good choice. Nevertheless, there were still few reports about the use of intraoperative skull traction and different fixation methods in treatment of AAS. Methods: From January 2012 to December 2018, a total of 86 cases were admitted to our hospital and diagnosed as AAS. All the patients received atlantoaxial reduction with the help of intraoperative skull traction and C1-C2 fixation. Clinical and radiological parameters were collected through chart review. Results: There were 86 cases included in this study. The mean operative time was 153.9 ± 73.9 min, and the mean amount of intraoperative blood loss was 219.1 ± 195.6 ml. 81 patients underwent posterior reduction, internal fixation and fusion. 5 patients underwent anterior release, followed by posterior internal fixation and fusion. 82 patients got satisfactory postoperative outcomes while complications occurred in 4 patients. Significant neurologic improvement was observed in these patients. Bone fusion was achieved on the midline sagittal reconstructed CT images at the latest follow-up in all these patients except 1 case. All the patients were followed up for 34.84 ± 15.86 months at average (range 12-60 months). The mean ADI value was 7.55 ± 1.67 mm at average preoperatively, and improved to 4.03 ± 1.21 mm postoperatively, and to 4.21 ± 0.99 mm at the latest follow-up. The mean A-A angle was 15.48 ± 9.82 degrees at average preoperatively, and improved to 21.61 ± 10.43 degrees postoperatively, and to 19.73 ± 8.13 degrees at the latest follow-up. The mean A-A height was 35.61 ± 7.66 mm at average preoperatively, and improved to 40.08 ± 8.5 mm postoperatively, and to 38.83 ± 6.97 mm at the latest follow-up. There were complications in 4 patients, including pedicle misplacement, pedicle screw fracture, infection and one death. Conclusion: Intraoperative skull traction can effectively facilitate the surgical procedures for ASS caused by different etiologies. Further research will be needed to investigate the safety and effectiveness of this method in the future.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of atlantoaxial subluxation by intraoperative skull traction and C1-C2 fixation

Guo

et al. 2020

BMC Musculoskelet Disord

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“…But the atlantoaxial structure must be integrated, including the lateral mass of atlas and axis vertebrae. Yin et al 7. took the transoral approach to release and reduce dislocation of atlantoaxial, and perform fixation at the same time, effectively avoid possible risk of spinal cord injury.…”

Section: Discussionmentioning

confidence: 99%

Corrective surgery for deformity of the upper cervical spine due to ankylosing spondylitis

Lin

et al. 2014

IJOO

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Rotational and flexion deformity of C1-C2 due to ankylosing spondylitis is rare. We did surgical correction in one such case by lateral release, resection of the posterior arch of C1 and mobilization of the vertebral arteries, wedge osteotomy of the lateral masses of C1 and internal fixation under general anesthesia. There were no vascular and neurological complications during the surgery. After operation the atlantoaxial rotational deformity was corrected and the normal cervical lordosis was restored. At 1 year followup his visual field and feeding became normal and internal fixation was stable.

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“…Ai [19] reported applied anatomy of transoral approach is suitable for anterior screw-plate fixation. Yin [20] designed transoral atlantoaxial reduction plate fixation for irreducible atlantoaxial dislocation and the postoperative effect was satisfactory. Oropharynx is a contamination situation, however.…”

Section: Discussionmentioning

confidence: 99%

The single transoral approach for Os odontoideum with irreducible atlantoaxial dislocation

2009

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We report a 52-year-old female patient with a 2-year history of local neck pain, decreased cervical spine rotation, progressive numbness and weakness of both arms. Preoperative, dynamic X-rays, computed tomography, three-dimensional computed tomography demonstrated a displaced Os odontoideum with irreducible Subluxation of C1/2. We used a single transoral approach release, reduction using an assistance of skull traction, bone fusion and stabilization in the treatment of Os odontoideum with irreducible alantoaxial dislocation. Postoperative, the patient was free of all symptoms and X-rays taken showed a stable fusion of C1/2 at 6th postoperative month. This technique in the treatment of Os odontoideum with irreducible alantoaxial dislocation is atraumatic and effective. And preoperative dynamic X-rays, computed tomography, three-dimensional computed tomography and MRI scans provided an invaluable aid to select this operative procedure.

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Transoral atlantoaxial reduction plate internal fixation for the treatment of irreducible atlantoaxial dislocation: a 2- to 4-year follow-up

Abstract: The TARP operation is a good choice for patients with irreducible atlantoaxial dislocation and has valuable clinical application.

Cited by 44 publications

References 5 publications

Surgical treatment of atlantoaxial subluxation by intraoperative skull traction and C1-C2 fixation

Surgical treatment of atlantoaxial subluxation by intraoperative skull traction and C1-C2 fixation

Corrective surgery for deformity of the upper cervical spine due to ankylosing spondylitis

The single transoral approach for Os odontoideum with irreducible atlantoaxial dislocation

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