Clinical Effect of Surgical Decompression and Stabilization on Spinal Cord Dysfunction in Atlantoaxial Dislocation

Kim, Hyun Jib

Abstract

The author analysed clinical effect of surgical decompression and stabilization on spinal cord dysfunction in 20 cases of atlantoaxial dislocation. Of 20 cases, 10 cases were related with trauma(either recent or remote), 4 with bony anomalies, 3 with inflammatory processes and remaining 3 of unknown etiologies. 9 cases had reducible dislocations and 11 cases were not reduced preoperatively. All cases were decompressed if necessary and stabilized via ventral transoral or posterior approaches. All cases except one, neurological symptoms and sings were improved or stabilized after operations. One patient who had been bedridden and had high preoperative CO2 retention, died 2 months after operation due to respiratory complications. In 3 of 10 ventrally decompressed cases, pharyngeal wounds were disrupted and it took more than 3 months of admission to heal. In 3 of 17 posterior fusion, solid bony fusion could be achieved by second operations. In conclusion, atlantoaxial dislocations can be cured by systematic decompression and fusion, but complication can be serious and troublesome.