Comparison of Atlantoaxial Intra-Articular Fusion and Posterior Structural Bone Grafting Techniques for Treating Atlantoaxial Dislocation.

BACKGROUND

The structural bone grafting (SBG) technique provided high fusion rate and satisfied outcomes for treating atlantoaxial dislocation, but it is unclear whether the atlantoaxial intra-articular cage (AIC) technique can provide clinical results comparable with SBG technique.

OBJECTIVE

To compare the outcomes of 2 bone graft techniques applied in posterior C1-C2 screw-rod fixation and fusion surgery for treating atlantoaxial dislocation.

METHODS

The data from 55 patients with atlantoaxial dislocation were retrospectively reviewed. The SBG technique had been used in 29 patients and the AIC technique in 26 patients. The outcomes were evaluated using the Japanese Orthopedic Association scale score, Neck Disability Index, and visual analog scale score for neck pain and compared between the 2 groups. The donor site complications were also recorded in SBG group, and donor site pain was assessed using a visual analog scale.

RESULTS

In the final follow-up, the bone fusion rate was 100% in both groups. No significant differences were found in the bone fusion time between the 2 groups ( P > .05). Postoperatively, the Japanese Orthopedic Association, Neck Disability Index, and visual analog scale score for neck pain indexes improved significantly within both SBG (all P < .05) and AIC groups (all P < .05). Nevertheless, there were no statistically significant differences between the 2 groups (all P > .05).

CONCLUSION

The SBG and AIC techniques were both effective for achieving atlantoaxial arthrodesis, and the AIC technique is a perfect alternative to the SBG technique when the posterior arch of C1 is incompetent.