Background Data: Atlanto-occipital dislocation is a rare and fatal condition.\nPain, limitation of movements, and weakness, were the main complaints of\npatients with upper cervical lesions. Internal fixation and fusion was indicated\nin all patients of Atlanto occipital dislocation with deficits. CT scan is\nthe imaging modality of choice for evaluation. Objective: To evaluate the efficacy\nand safety of rod and screw fixation in cranio-cervical instability. Study\nDesign: Retrospective study reviewed all patient treated by rod and screw fixation,\nthey were 12 patient operated for atlanto-occipital instability from April\n2013 to April 2016 in Alazher University Hospital Damietta. Pre and postoperative\ndata collection and analysis of the outcome were completed based\non the Frankel classification and grading. Patients and Methods: We operated\n12 patients, 10 with traumatic and 2 with pathologically diagnosed Atlanto\noccipital instability. From April 2013 to April 2016. All patients presented\nwith neck pain, limitation of neck movement, and neurological deficits.\nThe patients were investigated by standard plain X ray to the cervical\nspine, CT scan and MRI of the cervical spine pre-operatively, and they operated\nthorough posterior Cranio-cervical fixation. These patients followed\npost-operatively clinically for improving neural functions and radiologically\nfor alignment, stability, fusion and efficacy of hard ware fixation. Results:\nThe mean age of the studied cases was 42.1 years, trauma was the cause of instability\nin 10 patients, and 2 patients one with rheumatoid arthritis and one\nwith neoplastic lesion. The mean follows up period is 14.7 months. We used\nscrew rod system in posterior craniocervical fixation with iliac bone graft\nwithout operative or post-operative complications. All our patients were improved\nneurologically post-operatively and no hardware failure during the\nfollow up period. Conclusion: Craniocervical instability was rare condition,\nwith miss diagnosis and may be fatal condition. Posterior occipitocervical\nfixation when indicated can be done by various techniques. The screw rod\nsystem was the most upgraded used technique with immediate rigid fixation.\nSurgery in this area was possible with confident results.
Loading....