Department of Orthopedics, No.149 Hospital, The People's Liberation Army of China, Lianyungang, People's Republic of China.
Department of Orthopedics, Kunshan First People's Hospital, Jiangsu University, Kunshan, People's Republic of China.
Spine (Phila Pa 1976). 2019 Jan 1;44(1):E60-E66. doi: 10.1097/BRS.0000000000002754.
Retrospective comparative study.
To compare the outcomes of C1-C2 transarticular screw combined with C1 laminar hook (TAS+C1H) and C1-C2 transarticular screw combined with modified Gallie technique (TAS+G) for treating reducible atlantoaxial dislocation (AAD).
Both TAS+C1H and TAS+G fixation were 3-point fixation techniques for AAD. TAS+C1H technique was comparable to TAS+G technique in biomechanics. However, it is unknown whether it can achieve same outcomes as TAS+G technique.
Data of the 63 patients who underwent TAS+C1H or TAS+G fixation and fusion because of AAD were retrospectively reviewed. Bone fusion time was recorded. The outcomes evaluated by visual analog scale score for neck pain (VASSNP), Nurick scale, neck stiffness (none/mild/severe), patient satisfaction, and Neck Disability Index (NDI) were compared between two groups.
At the final follow-up, bone graft fusion rates were 100% in both groups (P > 0.05). Nurick scales were significantly improved in both groups (P < 0.05), but with no significant differences between groups (P > 0.05). There were no significant differences between two groups in VASSNP, neck stiffness, patient satisfaction, or NDI (all P > 0.05). There were no complications related to the surgical approach and instrumentation in either group.
Both TAS+C1H and TAS+G fixation were effective in the treatment of reducible AAD. TAS+C1H was safer than TAS+G because it could potentially reduce the risk of spinal cord and venous plexus injury associated with sublaminar cables.
回顾性对比研究。
比较经寰枢关节螺钉联合 C1 椎板钩（TAS+C1H）与经寰枢关节螺钉联合改良 Gallie 技术（TAS+G）治疗可复性寰枢关节脱位（AAD）的疗效。
TAS+C1H 和 TAS+G 固定均为 AAD 的三点固定技术。TAS+C1H 技术在生物力学方面与 TAS+G 技术相当。然而，尚不清楚它是否能达到与 TAS+G 技术相同的效果。
回顾性分析了 63 例因 AAD 行 TAS+C1H 或 TAS+G 固定融合的患者资料。记录骨融合时间。比较两组患者的颈痛视觉模拟评分（VASSNP）、Nurick 评分、颈部僵硬（无/轻/重）、患者满意度和颈椎残障指数（NDI）。
末次随访时，两组患者的植骨融合率均为 100%（P＞0.05）。两组患者的 Nurick 评分均显著改善（P＜0.05），但两组间无显著差异（P＞0.05）。两组间 VASSNP、颈部僵硬、患者满意度和 NDI 无显著差异（均 P＞0.05）。两组均无与手术入路和器械相关的并发症。
TAS+C1H 和 TAS+G 固定治疗可复性 AAD 均有效。TAS+C1H 比 TAS+G 更安全，因为它可能降低与椎板下电缆相关的脊髓和静脉丛损伤的风险。
3 级。
