Objective: To explore the clinical characteristics and treatment methods for complicated atlantoaxial dislocation.
Methods: A retrospective evaluation was done to summarize and analyze the clinical characteristics and complicated factors of 54 patients with complicated atlantoaxial dislocation who could not to be treated effectively by using conventional therapy in our hospital from February 2005 to October 2008. According to different complicated factors, different treatment methods mainly including transoral atlantoaxial reduction plate-III (TARP-III) operation, decompression procedure with deep grinding guided by computer aided design-rapid prototyping (CAD-RP), screw placement technique with CAD-RP guide plate and extensile approach surgery were performed.
Results: The average follow-up period was 24 months. Among 54 cases, 48 cases achieved immediate anatomic reduction completely and 6 cases almost achieved anatomical reduction. All the compressed spinal cords were decompressed sufficiently. The decompression rate was 86.0% and the improvement rate of nerve function was 77.8%. Two cases suffered postoperative intracranial infection.
Conclusion: Some cases of complicated atlantoaxial dislocation can be effectively treated by using TARP-III operation, decompression procedure with deep grinding guided by CAD-RP, individualized screw placement technique with CAD-RP guide plate and extensile approach surgery.