Liu Hu,Guo Dong,Li Chengxin,et al.Application of posterior atlantoaxial screw-rod fixation in the treatment of pediatric atlantoaxial instability and dislocation[J].Journal of Clinical Pediatric Surgery,,():462-466.[doi:10.3760/cma.j.cn101785-20260408-00161]
Application of posterior atlantoaxial screw-rod fixation in the treatment of pediatric atlantoaxial instability and dislocation
- Keywords:
- Atlantoaxial; Instability; Dislocation; Child; Screw-rod Fixation
- Abstract:
- Objective Toevaluate the feasibility,safety,and efficacy of posterior atlantoaxial screw-rod fixation in the treatment of pediatric atlantoaxial instability and dislocation.Methods A retrospective analysis was conducted on 106 patients under 18 years of age who underwent surgery at Beijing Children’s Hospital,Capital Medical University,between January 2012 and January 2022.The cohort included 61 males and 45 females,with a mean age of 6.4 years.The main etiologies included congenital malformations and atlantoaxial rotatory fixation.All patients were treated with posterior screw-rod fixation combined with autologous iliac bone grafting,and two patients additionally underwent transoral anterior release.Results The follow-up period ranged from 18 to 75 months,with a mean of 43.5 months.No intraoperative or postoperative complications related to neurological or vascular injury,nor instrumentation-related complications,were observed.The atlantodental interval decreased from 7.31±2.25 mm preoperatively to 2.94±1.98 mm postoperatively and at final follow-up.The effective spinal cord space increased from 13.38±3.79 mm to 19.45±3.82 mm.The JOA score improved from 14.83±1.91 to 16.85±0.82.All differences were statistically significant (t=13.614,-10.991,-12.362; all P<0.001).Internal fixation was well positioned,and clinical symptoms were relieved.Primary bone fusion was achieved in 100 patients (94.3%),while the remaining six patients achieved fusion after secondary bone grafting.Conclusion Posterior atlantoaxial screw-rod fixation is a safe and effective technique for treating pediatric atlantoaxial instability and dislocation.It provides reliable reduction and stabilization,improves spinal cord space,promotes fusion,and preserves neurological function.
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Memo
收稿日期:2026-4-8。
通讯作者:张学军,Email:zhang-x-j04@163.com