| 摘要 |
Seventeen patients with atlantoaxial instability were treated with posterior atlantoaxial transarticular screw fixation. These included six patients with nonunion of type II odontoid fracture, five with os odontoideum, three with rheumatoid arthritis, and three with ligamentous instability. In 15 cases, screw fixation was augmented with an interspinous C1-2 strut graft wired in place to provide three-point srabilization and to facilitate bone fusion; two patients had cancellous onlay grafts because of previous C1 laminectomies. All 17 patients (100%) developed osseous unions (mean follow-up period, 31 months). In conclusion, atlantoaxial transarticular screw fixation provides immediate multidirectional rigid fixation of C1-2 that is mechanically superior to wiring or clamp fixation. This technique maximizes success without the need for supplemental external rigid immobilization. |
