Efficacy Evaluation Of Instability Treated By Occipitocervical Fusion

Purpose:To evaluate the effectiveness of instability treated by occipitocervical fusion.Methods:47 patients of occipitocervical instability treated by occipitocervical fusion from August 2007 to April 2014 were reviewed. All the patients including 34 males and 13 females with age of 15-77 years, averaged (50.87±14.08) years were underwent occipitocervical fusion. The lesions included 33 cases of atlanto-axial fracture or dislocation by injury,12 cases of congenital occipitocervical anomalies, one case of upper cervical tumor and one case of rheumatoid arthritis. Japanese Orthopaedic Association (JOA), Visual analog symptom rating scale (VAS), pre-and post-operative imaging data were used for efficacy assessment.Results:All the cases were followed up for 8 to 88 months, averaged (45.79±16.12) months. Postoperative X-ray of 46 cases showed good fusion. The fusion rate was 97.9%. Mean preoperative JOA score and VAS score were (12.32±2.97) points and (6.55±.14) points while postoperative were (14.85±2.26) points and (1.91±1.06) points. Recovery rate of JOA is 54%.There are significant differences between preoperative and postoperative results (P<0.05).Conclusion:The results of the present study indicate that posterior occipitocervical fusion using the cervical pedicle screws and plate-rod systems is an effective surgical treatment for occipitocervical instability because of great biomechanical stability and improving fusion rate.