Reduction and arthrodesis with sublaminar spiral silk in atlantoaxial joint instability

Autor: Mustafa Gökhan Bilgili, Kadir Kotil, Selim Kayaci
Rok vydání: 2014
Předmět:
Adult
Joint Instability
Male
medicine.medical_specialty
Adolescent
Atlantoaxial stabilization
medicine.medical_treatment
Arthrodesis
Bone Screws
Silk
cervical spine
Young Adult
Postoperative Complications
Health Care Sciences and Services
Atlantoaxial stabilization
cervical spine
interlaminar fusion
medicine
Humans
Orthopedics and Sports Medicine
In patient
Sağlık Bilimleri ve Hizmetleri
Range of Motion
Articular
Child
Spinal cord injury
Reduction (orthopedic surgery)
Spiral
Retrospective Studies
business.industry
Mean age
Joint instability
General Medicine
Middle Aged
medicine.disease
Surgery
Atlantoaksiyel stabilizasyon
servikal omurga
interlaminar füzyon
Radiography
Spinal Fusion
Treatment Outcome
Atlanto-Axial Joint
Atlantoaxial instability
interlaminar fusion
Female
business
Follow-Up Studies
Zdroj: Volume: 48, Issue: 4 443-448
Acta Orthopaedica et Traumatologica Turcica
ISSN: 2589-1294
1017-995X
Popis: WOS: 000341802300011
PubMed ID: 25230269
Objective: The aim of this study was to evaluate the clinical and radiologic results of the use of thick spiral silk knotting instead of sublaminar wiring for C1-C2 arthrodesis in patients with atlantoaxial instability. Methods: We retrospectively evaluated 16 patients (10 females, 6 males; mean age: 43.4 years; mean follow-up: 34 months) with atlantoaxial instability who underwent C1-C2 fusion by reduction and sublaminar spiral silk knotting. All patients underwent open reduction, bounding both laminae with thick spiral silk instead of wiring and arthrodesis with autografting. Reduction rates, screw position and fusion rates were evaluated using computed tomography. Results: Preoperative mean atlantodental interval (ADI) was 8 (range: 6 to 11) mm and postoperative ADI was 2.1 (range: 0.5 to 2.5) mm. There was no dural or spinal cord injury. Complete reduction was observed in all cases. Fusion was unsuccessful in 1 case (6.25%). Postoperative mean flexion ADI was 10 mm and mean extension ADI was 1 mm. Graft separation between C1-C2 was observed in slice tomographic examination in one patient. Malposition was observed in 2 screws (4%). Conclusion: The sublaminar silk knotting technique appears to provide safe anatomical reduction. As this method is cheap and simple and does not require extra implantation, loosen, create neurologic compromise or cause radiologic crowding, it can be considered an alternative surgical technique to sublaminar wiring.
Databáze: OpenAIRE
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