Novel surgical classification and treatment strategy for atlantoaxial dislocations.

摘要: STUDY DESIGN Retrospective study of 904 patients with a diagnosis atlantoaxial dislocation (AAD), using novel surgical classification and treatment strategy. OBJECTIVE To describe strategy for AADs. SUMMARY OF BACKGROUND DATA AADs can result from variety etiologies, yet no comprehensive has been accepted that guides treatment. Because the rarity cases, however, also debated. METHODS During period 12 years, total AAD were recruited single academic institution. According to algorithm included preoperative evaluation dynamic radiograph, reconstructive computed tomography, skeletal traction test, cases classified into 4 types: I IV. Types II fused in reduced position posterior approach. Type III, which irreducible dislocations, converted reducible dislocations transoral release, followed by fusion. IV presented bony required osseous decompressions prior RESULTS Four hundred seventy-two as type I, 160 II, 268 Follow-up was range 2 years (average: 60.5 mo). Eight ninety-nine (99.4%) achieved solid Anatomic reduction 892 (98.7%), whereas had partial reduction. Neurological improvement seen 84.1% (512/609) myelopathy. The overall complication rate 9.1% (82/949). CONCLUSION Our applied those associated excellent clinical results minimal risk complications. LEVEL EVIDENCE 4.