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Treatment of irreducible atlantoaxial dislocation using the transoral atlantoaxial pedicle screw technique

A report of 10 cases

Therapie der nicht zu reduzierenden atlantoaxialen Dislokation mit transoralen atlantoaxialen Pedikelschrauben

Darstellung von 10 Behandlungen

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Abstract

Objective

The purpose of this work is to evaluate the outcome of the transoral atlantoaxial pedicle screw technique for the treatment of irreducible atlantoaxial dislocation (IAAD).

Patients and methods

A total of 10 patients with IAAD were treated using the transoral atlantoaxial pedicle screw technique. We compared preoperative and postoperative JOA (Japanese Orthopedic Association) scores and observed bone graft fusion rate of the atlantoaxial joint, and examined whether our technique was suitable for the treatment of IAAD.

Results

The mean preoperative and postoperative JOA scores (9.2 ± 0.63 and 12.9 ± 0.73, respectively) were significantly different (P < 0.05). The atlantoaxial rigid bony fusion rate was 100 % in 10 cases. All cases were followed up for an average of 5.1 years (range 3.5–6 years).

Conclusion

The transoral atlantoaxial screw reconstruction plate technique is a novel surgical technique for the treatment of IAAD in upper cervical diseases.

Zusammenfassung

Ziel

Evaluiert werden soll das Outcome nach Therapie einer irreduziblen atlantoaxialen Dislokation (IAAD) mittels transoraler atlantoaxialer Pedikelverschraubung.

Patienten und Methoden

Insgesamt 10 Patienten mit IAAD wurden mit transoral eingebrachten atlantoaxialen Pedikelschrauben behandelt. Wir verglichen prä- und postoperative JOA(Japanese Orthopedic Association)-Scores, beobachteten die Fusionsrate beim Knochengraft am Atlantoaxialgelenk und überprüften die Eignung der verwendeten Methode für die Behandlung einer IAAD.

Ergebnisse

Die Unterschiede zwischen den durchschnittlichen prä- und postoperativen JAO-Scores (9,2 ± 0,63 bzw. 12,9 ± 0,73) waren statistisch signifikant. Die rigide atlantoaxiale knöcherne Fusionsrate betrug 100 % in allen 10 Fällen. Im Durchschnitt lag die Follow-up-Zeit bei 5,1 (3,5–6) Jahren.

Schlussfolgerung

Die Methode der atlantoaxialen Schrauben-Platte-Rekonstruktion mit transoralem Zugang ist eine neue chirurgische Methode zur Behandlung der IAAD bei Erkrankungen der oberen Halswirbelsäule.

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Authors and Affiliations

  1. Department of orthopedics, Ningbo No. 2 Hospital, 41 Xi Bei Road, 315010, Ningbo, People’s Republic of China

    Yi Zheng MD

  2. Department of Orthopedics, Guangzhou Liuhuaqiao Hospital, 111 Liu Hua Road, 510010, Guangzhou, People’s Republic of China

    Zeng-Hui Wu MD, Qing-Shui Yin MD & Kai Zhang MD

  3. Ningbo Municipal Hospital of TCM, Ningbo, People’s Republic of China

    Yi-Hong Yin MD

Authors
  1. Yi Zheng MD
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  2. Zeng-Hui Wu MD
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  3. Yi-Hong Yin MD
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  4. Qing-Shui Yin MD
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  5. Kai Zhang MD
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Corresponding author

Correspondence to Zeng-Hui Wu MD.

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Conflict of interest

Y. Zheng, Z.-H. Wu, Y.-H. Yin, Q.-S. Yin, and K. Zhang state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Zheng, Y., Wu, ZH., Yin, YH. et al. Treatment of irreducible atlantoaxial dislocation using the transoral atlantoaxial pedicle screw technique. Orthopäde 45, 174–179 (2016). https://doi.org/10.1007/s00132-015-3219-4

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  • DOI: https://doi.org/10.1007/s00132-015-3219-4

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