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Journal of Korean Neurosurgical Society > Volume 28(7); 1999 > Article
Journal of Korean Neurosurgical Society 1999;28(7): 926-933.
Long Term Follow up and Clinical Results of Posterior C1/2 Fixation.
Do Heum Yoon, Young Soo Kim
Department of Neurosurgery, College of Medicine, Yonsei University, Seoul, Korea.
ABSTRACT
OBJECTIVE:
To determine the efficacy of various posterior fusion techniques in managing C1/2 instability. PATIENTS AND
METHODS:
Retrospective review of patients undergoing C1/2 posterior fusioin was undertaken with the aim of determining the long-term outcome of the selected procedures. Forty-two patients requiring posterior atlantoaxial fusion for various pathologies were treated with various instruments for internal spinal fixation. Forty-two patients underwent 45 procedures from 1990 to 1997, with a mean follow-up of 2.7 years(range 8 months-7 years)
RESULTS:
The most common disease processes were odontoid fracture(12 patients), os odontoideum(13), and rheumatoid instability(7). Nineteen interspinous wirings, 17 transarticular screw fixations, 9 halifax clamp applications were performed. Three of Halifax fixation and 2 of wiring failed in long term follow up. Among of them, bony fusion was failed in 3 patients which consequently required reoperation. All transarticular screw procedures resulted in successful fusions. CONCLUSIONS: Transarticular screw fixatioin has several potential advantages compare to other procedures as a technique for C1/2 posterior arthrodesis.
Key Words: C1/2 posterior fusion; Odontoid process fracture; Os odontoideum; Halifax clamp; Transarticular screw fixation
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