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Pedicle screw fixation can help reposition C1-C2 dislocation successfully
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Researchers investigated the effectiveness of using internal screw fixation via the C1 and C2 pedicle in cases of old odontoid fractures and found the method provided an effective and safe surgical approach.
The researchers retrospectively reviewed data for 21 patients with old odontoid fractures (13 men and 8 women; mean age, 46.5 years) who underwent internal screw fixation via the C1 and C2 pedicle. Prior to surgery, all patients underwent radiographic cervical anteroposterior examination with open mouth, lateral and hyperextension views. The researchers also used VAS scores for neck pain and cervical spinal cord functional Japanese Orthopaedic Association (JOA) score to evaluate the treatment’s effectiveness.
Sagittal CT reconstruction was performed 6 and 12 months after surgery to monitor fracture repositioning and C1-C2 fusion. The average VAS score for neck pain was significantly improved at the last follow-up examination, from 5.9 to 1.8. Patients with cervical spine injury also experienced a significant improvement in JOA scores, with an average improvement rate of 61%, according to the researchers.
Through postoperative images, the researchers observed that C1–C2 dislocation was satisfactorily repositioned in all patients. Radiographs and CT reconstruction at 1 year after surgery demonstrated trabecular continuity through the posterior arch of C1 and the lamina of C2. Additionally, bone fusion rate was 100%. There was no loosening or dislocation, and no C1 re-dislocation occurred at the final follow-up.
The researchers concluded the surgery offered few complications and was an effective treatment for old odontoid fractures associated with C1–C2 dislocation or instability. – by Robert Linnehan
Disclosures: The authors report no relevant financial disclosures.
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