One-stage anterior release and reduction with posterior fusion for treatment of irreducible atlantoaxial dislocation.

Abstract

To analyze the approach and feasibility of one-stage anterior release and reduction with posterior fusion for irreducible atlantoaxial dislocation. Ten male and 6 female patients, with an average age of 36 years, including 13 patients with old trauma, 2 with rheumatoid disease, and 1 with os odontoideum were studied. Anterior release and reduction was performed in the supine position. The atlas and vertebra dentate were fixed posteriorly and fused by one stage. All patients were followed up from 15 to 40 months (mean, 23 months), and all gained anatomic reduction and bone fusion. Six months postoperatively, the Japanese Orthopaedic Association (JOA) score of the 12 patients with cord symptoms had improved from 8.3 preoperatively to 13.9, with a mean improvement of 87.5%. Treatment of irreducible atlantoaxial dislocation with one-stage anterior release and reduction with posterior fusion is a reliable method. © 2009 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.