An 11-Year Review of the TARP Procedure in the Treatment of Atlantoaxial Dislocation
| Autor: | Qing-shui Yin, Fuzhi Ai, Zhao Hui Bai, Kai Zhang, Hong Xia, Zeng-hui Wu, Xiao-hong Mai, Xue-Shi Li, Jianhua Wang, Xiangyang Ma |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Decompression medicine.medical_treatment Bone Screws Joint Dislocations Young Adult 03 medical and health sciences 0302 clinical medicine Bone plate medicine Humans Internal fixation Orthopedics and Sports Medicine Joint dislocation Child Reduction (orthopedic surgery) Aged Retrospective Studies 030222 orthopedics Atlanto-axial joint business.industry Middle Aged Decompression Surgical medicine.disease Surgery Spinal Fusion Treatment Outcome medicine.anatomical_structure Atlanto-Axial Joint Child Preschool Spinal decompression Spinal fusion Female Neurology (clinical) business Bone Plates 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Spine. 41:E1151-E1158 |
| ISSN: | 1528-1159 0362-2436 |
| Popis: | Study design Retrospective study. Objective The aim of the study was to introduce the surgical techniques and evaluate the clinical outcomes of transoral atlantoaxial reduction plate (TARP) for the treatment of atlantoaxial dislocation. Summary of background data Researchers have reported on transoral plate internal fixation for the treatment of irreducible atlantoaxial dislocation (IAAD) without long-term follow-up and detailed clinical experience. Methods The clinical records of 388 patients with atlantoaxial dislocation (IAAD, 340 cases; fixed atlantoaxial dislocation [FAAD], 48 cases) who received the TARP procedure from April 2003 to September 2014 were retrospectively reviewed. They were treated separately with TARP-I or TARP-II (82 cases), TARP-III (248 cases), or TARP-IV (58 cases). X-ray and magnetic resonance imaging were used to evaluate the efficacy of reduction and the degree of decompression, respectively. The long-term clinical outcome was evaluated by Japanese Orthopaedic Association scoring and the Symon and Lavender standard. Results Immediate reduction was achieved for all the patients with IAAD (340/340), whereas anatomical reduction was achieved for 98.2% of patients (334/340). Anatomical reduction was achieved in 87.5% of patients with FAAD (42/48). The average degree of spinal cord decompression ranged from 75% to 100% with an average of 88.4%. The clinical data of 106 patients were evaluated in the latest follow-up (12-108 mo, average 60.5 mo). The average spinal cord improvement rate by Japanese Orthopaedic Association scoring was 62.1%. According to the Symon and Lavender standard, there were 85 cases rated as markedly effective, 104 cases as effective, and 2 cases as noneffective. The overall markedly effective rate was 80% and the effective rate was 98%. Conclusion The TARP procedure showed good anterior atlantoaxial release, reduction, decompression, and internal fixation for patients with IAAD and FAAD through a single anterior approach. It has the advantages of three-dimensional immediate atlantoaxial reduction and sufficient decompression. Level of evidence 3. |
| Databáze: | OpenAIRE |
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