郝定均(Hao Dingjun，Dept Spine Surg，Xi’an Redcross Hosp，Xi’an 710054)…∥Chin J Trauma.－2011，27(2).－121～124

Atlantoaxial pedicle screw fixation for old odontoid fracture combined with atlantoaxial instabili-ty

郝定均(Hao Dingjun，Dept Spine Surg，Xi’an Redcross Hosp，Xi’an 710054)…∥Chin J Trauma.－2011，27(2).－121～124

ObjectiveTo explore the clinical effect of the trans-atlantoaxial pedicle screw-rod internal fixation and fusion in treatment of old odontoid fracture combined with atlantoaxial instability.MethodsThe study involved 48 patients with old odontoid fractures combined with atlantoaxial instability treated with trans-atlantoaxial pedicle screw-rod internal fixation and fusion from January 2005 to January 2010.There were 30 males and 18 females，at average age of 45.1 years old(19 ～ 56 years).All the patients underwent the skull traction preoperatively.ResultsA total of 192 pedicle screws(96 screws for atlas and another 96 for axis)were implanted in all 48 patients who obtained satisfactory atlantoaxial reduction，with no spinal cord injuries.The operation lasted for 155 min on avarage，with blood loss for 370 mL on avarage.There were three patients with vertebral artery injury and three with inferior posterior arch fracture of atlas during operation.All the patients were followed up for 46.6 months on avarage(range，9 ～ 64 months)，which showed bone fusion at 6 months after operation，with no loosening，displacement，instability or breakage of screws.JOA score was improved from preoperative 7.1 ±2.8 to postoperative 13.3 ± 2.1(P ＜ 0.005).ConclusionAltantoaxial pedicle screw fixation is a reliable and effective method for treatment of atlantoaxial instability.15 refs，1 fig.

(Authors)