Analysis of surgical strategies and efficacy in the treatment of Os odontoideum with atlantoaxial dislocation

Journal of Orthopaedic Surgery and Research, 2023 · DOI: https://doi.org/10.1186/s13018-023-03517-x · Published: January 8, 2023

Surgery Orthopedics Spinal Disorders

Simple Explanation

This study investigates different surgical approaches for treating os odontoideum (OO) with atlantoaxial dislocation (AAD), a condition where a bone fragment at the top of the spine causes instability and potential spinal cord compression. The researchers analyzed data from 56 patients, classifying their AAD into four types and using different surgical techniques based on the classification to correct the dislocation and stabilize the spine. The study found that specific surgical strategies, including posterior fixation and fusion, combined with translateral mass release or transoral release, can effectively treat OO patients with AAD, improving neurological function and achieving spinal fusion.

Study Duration

January 2017 to June 2021

Participants

56 OO patients with AAD

Evidence Level

Not specified

Key Findings

1
OO patients with irreducible AAD can be treated by translateral mass release or transoral release combined with posterior fixation and fusion
2
Posterior fixation and fusion were conducted on 30 cases of type I and 10 cases of type II.
3
The JOA score increased from 9.58 ± 1.84 points before operation to 13.09 ± 2.68 points at 3 months after operation

Research Summary

This study retrospectively analyzed 56 patients with os odontoideum (OO) and atlantoaxial dislocation (AAD) to determine effective surgical strategies. AAD was classified into four types, and surgical approaches were tailored accordingly, including posterior fixation and fusion, translateral mass release, and transoral release. The study concluded that appropriate surgical strategies based on AAD classification can effectively treat OO patients, improve neurological function, and achieve successful spinal fusion.

Practical Implications

Surgical Strategy Selection

Classification of AAD guides selection of appropriate surgical techniques.

Irreducible AAD Treatment

Translateral mass release or transoral release combined with posterior fixation can effectively treat irreducible AAD.

Prognosis Indicators

Long disease duration and spinal cord atrophy may indicate a poorer prognosis.

Study Limitations

1
Small sample size
2
Retrospective nature
3
Lack of a control group

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