[Repair and re-establishment to traumatic upper cervical instability].

OBJECTIVE

To summarize and analyze the therapeutic effect of traumatic upper cervical instability and investigate therapeutic methods and effect.

METHODS

There were 19 patients with traumatic upper cervical instability (male 16, female 3), aged from 21 to 56 years,included 3 cases of atlas fracture, 10 cases of dens fracture, 3 cases of axis pedicle fracture, 3 cases of atlanto-axial subluxation. Among them, 6 cases included 1 case of dens fracture, 1 case of dens fracture affiliated with atlas fracture, 1 case of axis pedicle fracture, 3 cases of atlanto-axial subluxation were treated conservatively and the other 13 cases were treated by operations.

RESULTS

Nineteen cases were followed up for 1.8 years in average (6 months to 6 years). According to JOA standard for evaluation, the rate of improvement was 42.5% and 87.0% for conservative treatment and operation respectively.

CONCLUSION

Traumatic super cervical unsteadiness should be diagnosed and treated early. Under the condition of upper cervical vertebra being completely fixed,the function of cervical vertebra to maximum extent could be reserved when choosing operation method. Especially, the precise fusion of upper cervical vertebra plays a vital role of long-term efficacy.