Modified technique of transoral release in one-stage anterior release and posterior reduction for irreducible atlantoaxial dislocation

作者: Haoning Ma , Liang Dong , Chuyin Liu , Ping Yi , Feng Yang

DOI: 10.1016/J.JOS.2015.10.012

关键词:

摘要: Abstract Background One-stage anterior release and posterior reduction is one of the most effective methods for irreducible atlantoaxial dislocation. However, criteria appropriate tissue successful yet to be confirmed. Hence, an assistant technique using transoral approach verify satisfactory required. To evaluate efficacy modified dislocation (IAAD) with patients underwent one-stage reduction. Methods Between January 2009 June 2014, 23 consecutive diagnosed IAAD free from bony union between C1–C2 facet joints on reconstructive computed tomography scan after no response 2 weeks skull traction. During release, elevator was used as a lever repeatedly confirm 3–5 mm bilateral joint space lateral masses atlas axis. The accomplished since achieved. After instrumented fusion were subsequently performed. Results All observed average 18 (range 6–50) months. Nineteen achieved complete while four had incomplete Significant differences in pre- postoperative JOA scores cervicomedullary angle (CMA) found. Twenty-one presenting myelopathy score 12.9 at final follow-up, improved 7.8 before surgery. mean CMA 143.5° postoperatively 101.8° preoperatively. Bony confirmed all cases under radiologic assessment during follow-up; there instrument failures. Conclusion provides achieve good without excessive or intraspinal manipulation, proving its value IAAD.

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