Clinical Study Of The Feasibility And Methods Of Atlantoaxial Pedicle Screw Placement

ObjectiveTo explore the feasibilities, methods of atlantoaxial pedicle screw placement by the treatment of upper cervical diseases.MethodsFrom September 2009 to January 2010,17 upper cervical diseases patients were treated with atlantoaxial pedicle screw internal fixation system. There were 9 males and 8 females, ageing 19 to 58 yea rs. Of 17 cases,2 cases of congenital malformation of atlas,1 cases of atlas fracture,1 cases of rupture of the transverse ligament,4 cases of Os odontoideum,2 cases of old odontoid fracture,6 cases of new odontoid fracture and lcases of tumor of C2. The odontoid fractures were classified according to Anderson and D'Alonzo, which included Anderson II for 6 cases and Andersonâ…¢for 2 case. The examination of X-ray film,CT and MRI were performed and the height of atlas posterior arch below the vertebral artery sulcus were measured preoperatively with PACS/RIS to assess the suitability of placement.ResultsThe mean operaive time and bleeding amount were 150min(100-300min) and 400m 1 (50-810m 1) respectively. No injuries to the vertebral a rtery and spinal cord were observed. All patients were followed up 3-21 months. The clinical symptoms were improved in some extents and the screws were verified to be in a proper position, no breakage or loosening of screw and rob occurred. All patients achieved a solid bone fusion after 3-6 months.Conclusion1.Atlantoaxial pedicle screw placement is feasible for the treatment of upper cervi-cal diseases, which has better outcomes, wider indications if conducted properly.2. If the height of atlas posterior arch below the vertebral artery sulcus is greater than 2.0 mm, atlas pedicle screw should be given priority.