| Clinical and radiological comparison of treatment of atlantoaxial instability by posterior C1-C2 transarticular screw fixation or C1 lateral mass-C2 pedicle screw fixation. | |
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MedLine Citation:
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PMID: 20399666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We compared the clinical and radiological results of posterior atlantoaxial fixation surgery using transarticular screws to those using a polyaxial screw-rod system in 55 patients with symptomatic atlantoaxial instability. Patients underwent posterior C1-C2 fixation: 28 patients (group 1) underwent C1-C2 transarticular screw fixation and 27 patients (group 2) underwent C1 lateral mass-C2 pedicle screw fixation. Patients were followed-up for at least 24 months. The clinical and radiological results were evaluated in the early postoperative period and at 3, 6, 12 and 24 months after surgery. Long-term postoperative stability and bone fusion were examined. After surgery, 93% of patients in group 1 and 96% of patients in group 2 were free of neck pain. The solid fusion rates were 82% for group 1 patients and 96% for group 2 patients at 12 months (p<0.092). In group 1, three patients showed fibrous union. Four patients had hardware failure due to a screw malposition (one in group 1) and pseudoarthrodesis (two in group 1 and one in group 2). One patient in group 1 had cerebrospinal fluid leakage. One patient in group 2 had occipital neuralgia. One vertebral artery injury occurred during the screw placement in group 1 and another in group 2 during the muscle dissection. C1-C2 transarticular screw fixation and C1 lateral mass-C2 pedicle screw fixation both produced excellent results for stabilization of the atlantoaxial complex, but the radiological outcome tended to be superior in C1 lateral mass-C2 pedicle screw fixation. |
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Authors:
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Sun-Ho Lee; Eun Sang Kim; Joo-Kyung Sung; Yeun-Mook Park; Whan Eoh |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia Volume: 17 ISSN: 1532-2653 ISO Abbreviation: J Clin Neurosci Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-05-31 Completed Date: 2010-11-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9433352 Medline TA: J Clin Neurosci Country: Scotland |
Other Details:
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Languages: eng Pagination: 886-92 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Atlanto-Axial Joint / radiography, surgery* Bone Screws* Cervical Atlas / radiography, surgery Cervical Vertebrae / radiography, surgery* Child Female Follow-Up Studies Humans Internal Fixators* Joint Instability / radiography, surgery* Male Middle Aged Odontoid Process / radiography, surgery Retrospective Studies Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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