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| YAN Yingzhao,WANG Yongli,WANG Xiangyang.A modified bone graft method for posterior atlantoaxial arthrodesis and occipitocervical fixation[J].Chinese Journal of Spine and Spinal Cord,2017,(1):43-47. |
| A modified bone graft method for posterior atlantoaxial arthrodesis and occipitocervical fixation |
| Received:November 18, 2016 Revised:December 26, 2016 |
| English Keywords:Upper cervical instability Atlantoaxial joint Occipitocervical fixation Bone graft Internal fixation |
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| English Abstract: |
| 【Abstract】 Objectives: To evaluate the clinical results of a modified bone graft method for posterior atlantoaxial arthrodesis and occipitocervical fixation. Methods: A modified bone graft method was designed. From January 2011 to January 2013, 32 patients including odontoid nonunion in 21 patients, atlantoaxial instability in 6 patients and basilar invagination in 5 patients, there were 27 cases undergoing posterior atlantoaxial arthrodesis, and 5 cases undergoing occipitocervical fixation plus this bone graft method. The autogenous granulated cancellous bone was grafted between the arch of C1 and C2 or the arch of C2 and occipital. A few cortical bone chips were laid on the surface of compacted cancellous bone graft. Following the placement of two pieces of gelatin sponge, absorbable suture was used to fix the structure on internal fixation device or soft tissue bilaterally and form a net structure. All patients were followed up and immobilized by cervical collar after operation. The bone union rate was reviewed. Results: All patients completed operation successfully and were followed up for an average of 19.1±7.2 months(5-38 months). There was 1 case with postoperative retropharyngeal infection after transoral release and posterior reduction by pedicle screw instrumentation. The infection was controlled after two weeks of antibiotic therapy. In this series, all cases showed satisfactory screw fixation and bone graft intraoperatively and no incidence of postoperative reduction loss or pseudarthrosis was noted. All cases presented with bony union at 3-6 months of follow-up. Conclusions: Solid fusion can be achieved for posterior atlantoaxial arthrodesis and occipitocervical fixation by using this modified bone graft method. |
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