Retrospective Analysis On The Fixation Of Irreducible Atlantoaxial Joint Dislocation Within The Anterior And Posterior Approaches

Purpose: This article conducts retrospective analysis on the documents aboutirreducible atlantoaxial jointtreated with the methods of anterior and posterior internal fixation through oropharyngeal releaseto evaluate the effects and clinical values of the current two kinds of major operational methods including the internal fixation byposterior pedicle screw reduction through oropharyngeal releasing reduction and the internal fixation with reduction steel plate through oropharyngeal release reduction.Methods: Computer has been taken to retrieve the domestic databases like Wanf, Cq Vip, Chinese biomedical,Pumed、Springer、Sciencedirect、Wiley、Proquest and nature database, and methods like manual retrievalhave been taken to collect meeting documentations and conductdocument retrieval without limitation on type of language.All the documents on the operational treatment of irreducible atlantoaxialdislocation were collected so as to extract age distribution, case numbers, distribution of the medical causes of the cases, JOA evaluation before and after the operations,the cornua of spinal cord of the medulla, the minimum value of the sagittal diameter of spinal canal, improvement rate and complications, thus obtaining related evidences on whether there were differences in these two kinds of operational methods.Results: Altogether 26 researches have been integrated into this research including 386 patients withirreducible atlantoaxialdislocation.t and ptest have been conducted on the extracted value materials. It has been shown that there is no significance on the age distribution, medical cause distribution, and mean following-up time between the cases fixed byposterior vertebral pedicle screw reduction through oropharyngeal releasing reduction and thosefixed byreduction steel plate through oropharyngeal anterior atlantoaxial joints release reduction.However, in the improvement of JOA scores before and after the operation,average operating time the method of ixation by reduction steel plate through oropharyngealreductionfwas better thanixation by posterior vertebral pedicle screw reduction through oropharyngeal releasing reduction. And the minimum value of the sagittal diameter of spinal canal, the method of fixation by posterior vertebral pedicle screw reduction through oropharyngeal releasing reduction was better than that of fixation by reduction steel plate through oropharyngeal reduction. But there is no significance on the cornua of spinal cord of the medulla between them.Conclusion:The operational method of fixation by posterior vertebral pedicle screw reduction through oropharyngeal releasing reduction and that of fixation by reduction steel plate through oropharyngeal reduction have their drawbacks and advantages.both will be very good to complete the surgical operation of Irreducible atlantoaxialdislocation. In clinical practice, treatment selection irreducible atlantoaxial surgical method still relies on adequate preoperative assessment of the patients and the experience of the surgeon to make a choice.