Evaluation Of The Clinical Efficacy Of Atlantoaxial Rotatory Subluxation In Children Treated With Posterior Approach Atlantoaxial Pedicle Screw Rodsystem

Objective: To evaluate the clinical efficacy of internal fixation of the posterior approach pedicle screw rodsystem in the treatment of Atlantoaxial Rotatory Subluxation(AARS)in children.Methods: 11 children with AARS in the Children’s Hospital of Chongqing Medical University at the Department of Orthopaedic I from January 2018 to January 2021 were enrolled.All patients were treated with internal fixation of the posterior approach pedicle screw rodsystem.We evaluated the clinical efficacy by visual analogue score(VAS),cervical spine score of Japanese Orthopaedic Association,space available for the cord(SAC),atlanto-debtal interval(ADI),rotatory angle of the Atlas on Dentata(RAAD,variance of Bilateral Lateral Atlanto-Dental Space(VBLADS)and range of motion(ROM).Results: The surgical procedure was smooth in 11 children,with no spinal cord or vertebral artery injury,with an average operating time of144.2 minutes and an average bleeding volume of 127.8 ml.The VAS [5.88±1.83 vs.2.06±1.35 points],JOA score [11.11±1.45 vs.14.44±0.98 points,final follow-up was 16.33±0.50],SAC [9.91±1.84 vs.14.31±0.98 mm,final follow-up was 16.00±0.82],ADI [5.46±1.61 vs.2.48±0.71 mm,final follow-up was 1.74±0.65],RAAD [37.11±21.03° vs.5.88±3.18°,final follow-up was 5.16±3.72°] were significantly improved compared with preoperative.Range of motion Clinical symptoms were all improved: these were reflected in(1)significant relief of neckache;(2)reduction of cervical medullary compression;(3)complete correction of cervical deviation(4)significant improvement of cervical mobility.All data were tested non-parametrically and the differences were statistically significant(P< 0.05).Conclusion: Internal fixation of the posterior approach pedicle screw rodsystem in the treatment of AARS is a safe and reliable treatment modality,which can effectively relief neckache,improve cervical mobility and neurological function,restore the normal anatomical relationship of the atlantoaxial spine,and rebuild stability.