Abstract：Objective To explore the clinical outcome of the treatment of craniovertebral anormalies through occipitocervical fusion by inter-diploe screw fixation.Methods From January 2010 to January 2013, 15 patients (9 males, 6 females) in the First Affiliated Hospital of University of South China were diagnosed with craniovertebral anormalies. The age ranged from 29 to 60 years(40.4±8.2) years. Eight patients had Arnold-Chiari deformitory, 5 patients had basilar invagination with os odontoidem, 2 patients had Klippel-Feil deformitory. All the patients had symptoms of spinal medulla compression. The Japanese orthopaedic association(JOA) score of preoperation ranged from 6 to 10 (8.1±1.7). All the patients received head-shoulders traction through modified Halo-vest for 1-2 weeks. All cases received occipitocervical fusion by inter-diploe screw-rod-pedicel screw system.Results All patients underwent this technique operation successfully. The mean operation time was 100-220 min(140.2±30.5) min, and blood loose was 190-710 ml(272.2±73.4) ml. There was no neurological function worsen and severely complications. The JOA after operation 3 days was 9-14 (11.0±2.1), there was statistical differences compared to preoperation (t=0.003, P<0.05). The postoperatively radological films indicated all the inter-diploe screw locations were satisfactory, there was no screw penetrating the medial occipital plate. All cases were followed up for 12-36 months(22.0±6.3) months. Bone graft fusion was obtained in 3-9 months (5.1±2.7) months. There was no internal fixation breakage and loosening. The JOA score of last follow-up was 12-16 (14.1±1.6) , there was statistical differences compared to preoperation(t=0.002, P<0.05). All patients with limb numbness, muscle weakness and other symptoms were obviously improved than preoperation.Conclusions Occipitocervical fusion using inter-diploe screw-rod-pedicel screw system, is an effective method for the treatment of craniovertebral anormalies with the advantage of rigid fixation, simple operation and convenient bone graft.
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Yao Nyuzhao, Wang Wenjun, Wang Lushan, Yan Yiguo, Wang Cheng, Zhu Yiping. Treatment of craniovertebral anormalies through occipitocervical fusion by inter-diploe screw fixation. Chinese Journal of Anatomy and Clinics, 2014, 19(5): 406-410.
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2014, Vol. 19 
