Cervical pedicle screws fixation treatment the atlantoaxial instability of axis burst fractures

Background: Although the cervical pedicle screws and rods were used for atlantoaxial instable, the axis fractures still a challenge for spine surgeon. Objective: This study was to evaluated the clinical outcomes of axis burst fractures had C1C3 pedicles screws fixation treatment. Methods: From June 2014 to July 2018, 45 patients with axis fractures were enrolled in this study; 23 patients was odontoid underwent C1C2 pedicles screws fixation, and 21 patients was odontoid combine body fractures had C1C3 pedicles screws fixation. The clinical outcomes of pain relief (visual analog scale, VAS), functional disability (neck disability index, NDI) were recorded at baseline and at the final follow-up. Results: The pain index and NDI were all significantly improved when compared to pretreatment (P 0.05). All patients, suffered from severe mechanical upper cervical neck pain at pre-operative, were pain free post-operation. Pre-operative neurological examination was normal in all patients, and remained the same after surgery. All cases showed normal neurological function at the final follow-up. No vascular or neurological complication was noted. The fracture healing and the bony union of the fixed segments were revealed in all cases on CT views. Implant failure and instability were not seen on lateral flexion/extension radiographs of the cervical spine. Conclusions: Cervical pedicle screws fixation was effective and safe procedures in the treatment of traumatic spondylolisthesis of axial fractures. The atlantoaxial instable of axis burst fractures can be managed with C1-C3 pedicles screws fixation.