The Clinical Study Of Tans-Oropharynx Approach Fixation And Posterior Fixation For The Treatment Of The Unstable Atlas Fracture

Objective:Studying the single segmental anterior and limited internal fixation in the treatment of unstable type of the safety and efficacy of the unstable atlas fracture.Methods:22 patients who had the unstable atlas fracture in Guangxi Orthopaedics hospital during the period of September 2010-September 2014 were divided into two groups (group A and group B) according to their condition:In which 11 patients of group A of transoral approach atlas single segment of mini plate internal fixation, and 11 patients of group B underwent posterior atlas single section nail plate system internal fixation. Through comparing and analyzing two groups with blood loss of the operation, the distance from the occipital condyle joint center to the edge of atlanto-axial vertebral body apex, postoperative cervical activity, VAS score and Frankel standard. We randomly extracted 100 patients of normal cervical lateral slice in imaging system of GuangXi Orthopaedics hospital in random sampling and measured the distance from the occipital condyle joint center to the edge of atlanto-axial vertebral body apex.Through SPSS 16.0, studied the curative effect and difference between anterior and posterior atlas single segmental internal fixation.Results:Group A of transoral approach atlas single segment of mini plate internal fixation and group B underwent posterior atlas single section nail plate system internal fixation, blood loss of the operation of group A (20 ± 10.5 ml) and group B (150±24.5 ml), statistically significant. After the operation 6 months the patients of the two groups achieved osseous healing. Internal fixation had no breakage. VAS score had no statistical difference. The neck,pillow and shoulder’s pain disappeared and the feeling was normal. Nerve functions are restored to Frankel classification E. The height of pillow atlanto-axial complex got recovery,and there had no significant difference between two groups,(P> 0.05)and the same to normal control group(P>0.05). Postoperative cervical activity was nearly normal and no significant difference between two groups (P>0.05).Blood loss of the operation of group A was(20±10.5)ml,group B was (150±14.5)ml. There had significant difference between two groups(P<0.05). One patient in group A who appeared occlusion joint subluxation with front teeth fracture. Two groups of intraoperative no other severe complications after surgery.Conclusion:The clinical effect of anterior and posterior atlas single segmental internal fixation in treatment of the unstable atlas fracture is well. They both can reestablish the activity and stabilization of cervical vertebra through recovering the completeness of atlas and the height of C0-C1-C2.But the indications and surgical risks between two surgical procedures have certain difference, so it needs to evaluate and choice carefully in clinic.