J Korean Neurosurg Soc.  1997 Dec;26(12):1659-1666.

Surgical Treatment of Instability of Upper Cervical Spine Associated with Trauma

• Lee CH
• Kim ES
• Whang SH
• Moon BC
• Park YG
• Baek SH
• Park IS
• Jung JM
• Han JW

Abstract

With the aim of determining the outcome of surgery, a review of patients undergoing trauma-associated atrantoaxial arthrodesis. Between 1993 and 1997, 16 patients underwent 19 proceedures, with a follow-up period of between six and 29 months. The most common reasons for surgery were odontoid fracture(n=12), os odontoideum(n=1) procedure, and neurofibrimatosis type I(n=1). Ten posterior wiring, four Halifax clamp application, one anterior screw fixation of dens, two transarticular screw fixations, and one staged operation(anterior odontoiddectomy and posterior occipitocervical fusion) were performed. All patients has been surgically managed for about three months with a Halo-vest or rigid cervical neck collar, during which time three complications associated with operative procedures arose : Halifax clamp dislodgement, malunion and subluxation kyposis. In 15 of 16 patients, fusion was successful. In caes involving complicated atlantoaxial dislocation, the authors recommend postoperative Halo-vest immobilization for sucessful fusion after posterior C1-C2 wiring or Halifax clamping

Keyword

Atlantoaxial arthrodesis; Halo-vest immobilization

MeSH Terms

Arthrodesis
Constriction
Dislocations
Follow-Up Studies
Humans
Immobilization
Neck
Spine*
Surgical Procedures, Operative