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The application of atlantoaxial screw and rod fixation in revision operations for postoperative re-dislocation in children

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

We evaluate the feasibility, safety, and efficacy of atlantoaxial screw and rod fixation for revision operations in the treatment of re-dislocation after atlantoaxial operations in children.

Methods

Eight consecutive children with atlantoaxial instability required a revision operation due to atlantoaxial re-dislocation caused by the failure of the initial posterior wire fixation. The children were 5–11 years of age with an average age of 8.5 years. The posterior atlantoaxial screw and rod fixation and fusion operation was then performed. Autograft bones harvested from rib (in 3 patients), local bone (2 patients), and the iliac crest bone (3 patients) were used.

Results

There were no complications such as vertebral artery or spinal cord injury during the operations or loosening or fracture of the fixations after the operations. Stability and reduction of the atlantoaxial segments were achieved in all patients postoperatively. Follow-up time was 24–55 months, with an average of 35 months. All patients achieved solid osseous fusion demonstrated on plain radiographs or CT scanning. Atlantoaxial screw and rod fixation is feasible in children and may be considered for use during the initial operation in the treatment of atlantoaxial dislocation in children to minimize the need for a revision operation.

Conclusion

If a revision operation is required, atlantoaxial screw–rod fixation is a safe and effective method. Because the anatomical structure is complicated in revision operation patients, CAD-RP technology could guide the the procedures of exposure and screw placement.

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Acknowledgments

This work was supported by Fund of Medical Science Research of 12th Chinese Five-Year Plan (NO: BWS11C065).

Conflict of interest

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Authors and Affiliations

  1. Department of Orthopedics, Guangzhou General Hospital of Guangzhou Military Command, P.O. 510010, No. 111 Liuhua Avenue, Guangzhou, People’s Republic of China

    XiangYang Ma, QingShui Yin, Hong Xia, ZengHui Wu, JinCheng Yang, JingFa Liu, JunJie Xu & Feng Qiu

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  1. XiangYang Ma
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  2. QingShui Yin
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  3. Hong Xia
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Correspondence to XiangYang Ma.

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Ma, X., Yin, Q., Xia, H. et al. The application of atlantoaxial screw and rod fixation in revision operations for postoperative re-dislocation in children. Arch Orthop Trauma Surg 135, 313–319 (2015). https://doi.org/10.1007/s00402-014-2150-1

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  • DOI: https://doi.org/10.1007/s00402-014-2150-1

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