Document Type
Original Article
Abstract
Background: in recent years, proper management of posttraumatic craniocervical instability is possible. However, there is a paucity of literature with long follow-up of these patients. Purpose: To assess outcomes after surgical treatment of posttraumatic instability with occipitocervical fixation with or without fusion. Methods: Among 20 patients with posttraumatic unstable craniocervical junction who underwent occipitocervical fixation there was an equal number of both females and males with a mean age of 62.85 ± 17.23 years. The outcomes of NDI, neck pain VAS, neurological assessment by ASIA score, imaging, complications, and bony fusion were assessed. Radiological assessment of anterior dental interval (ADI), posterior dental interval (PDI), and posterior Occipito cervical angle (POCA). RESULTS: Clinically all patients presented with neck pain and only one with tetraplegia. The mean follow-up was 90.8 months. A solid bony fusion was achieved in 100 % of the patients. The NDI and the VAS improved significantly from 26 ± 6.4 and 7.7 at the presentation to 15.3 and 3.6 at the final follow-up. The anterior and posterior atlantodental interval (AADI, PADI), and the posterior occipitocervical angle (POCA) improved significantly. One patient required early revision. CONCLUSION: Occipitocervical fixation with or without fusion can be considered a valuable option in the treatment of instability with a high fusion rate and fewer complications. Temporary occipital fixation may be considered with later removal but may be associated with unintended occipitoatlantal fusion.
Keywords
Craniocervical; Instability; Atlas fracture; odontoid fracture; Fusion.
How to Cite This Article
Ismail, Mohamed Ahmed; Boehm, Heinrich; El Ghait, Hussein Abou; and Akar, Ahmed
(2023)
"Outcomes of occipitocervical fixation and fusion in posttraumatic craniocervical instability,"
Al-Azhar International Medical Journal: Vol. 4:
Iss.
2, Article 27.
DOI: https://doi.org/10.58675/2682-339X.1683
