Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Τρίτη 2 Μαΐου 2017

Surgical Intervention for Unstable Craniovertebral Junction Anomalies with a narrow C2 pedicle.

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Surgical Intervention for Unstable Craniovertebral Junction Anomalies with a narrow C2 pedicle.

World Neurosurg. 2017 Apr 27;:

Authors: Darwazeh R, Liu Q, Deng L, Xia J, Elzain MA, Darwazeh M, Sharma P, Zhang B, Yan Y

Abstract
OBJECTIVE: To investigate and report a novel surgical technique of screws insertion and posterior surgical reduction as well as explore its clinical results.
METHODS: From September 2008 to September 2012, 41 cases of unstable craniovertebral junction anomalies with a narrow C2 pedicle were treated at our department. All patients underwent "posterior reduction and internal fixation of the occipital bone with superior or inferior articular process of C2 and lateral mass of C3 on the narrowed C2 pedicle side -for non-narrowed C2 pedicle side, the screw was only inserted into C2 pedicle without extending the fixation to C3 vertebrae- using a titanium screw-rod (plate) fixation system". The pre- and post-operative Atlantodens Interval, Chamberlain's line, McRae's line and Cervicomedullary angle were all measured. In addition, the pre and post-operative Japanese Orthopedic Association score was used to evaluate the cervical myelopathy.
RESULTS: A total of 134 screws were inserted into C2 pedicle (30 screws), superior (35 screws) or inferior (17 screws) articular process of C2 and the lateral mass of C3 (52 screws). There was a significant statistical difference between the pre and post-operative results in the reduction of the odontoid process, decompression of the upper cervical spinal cord and medulla as well as the improvement of neurological functions (P< 0.05). All patients have exhibited a major neurological improvement and solid bony fusion.
CONCLUSION: This novel surgical technique is safe, feasible and effective for the treatment of unstable craniovertebral junction anomalies with a narrow C2 pedicle.

PMID: 28457924 [PubMed - as supplied by publisher]



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