The Clinical Efficacy Of Posterior Osteosynthesis Of The Atlas In Treatment With Atlas Fracture And The Changing Of The Height Of Atlanto-Occipital Complex

Purpose To evaluate the efficacy of Posterior Osteosynthesis of the Atlas in the treatment with Atlas fracture and the influence to the effica cy by changing of the height of atlanto-occipital complex.Methods Selected 27 patients with unstable Atlas fracture who treat ed at the first Affiliated Hospital of Guangxi Medical University into the study from 2012 to 2016.Using themselves as the referents.Before oper ation,measuring the length(R-J length)from the median point of the lower edge of atlantoaxial vertebrae to the McGregor line(the line from trailing edge of the hard palate to the lower margin after the foramen magnum)as a A group.After operation,Remeasured the R-J length as group B.Evalu ated the change of R-J length before and after operation,the range of cer vical spine motion after operation,the VAS score,the frankel classification,and so on.Meanwhile,choosing 106 patients whose cervical vertebra were normal from the first Affiliated Hospital of Guangxi Medical University of the PACS system as the control group.Using SPSS 23.0 software to a nalysis statistical data.Results the R-J length from 106 normal people(control group)were 42.69±2.60 mm.A group:Before the operation of the unstable Atlas fractu re,the R-J length were 38.94±3.19 mm versus 43.25±2.65 mm in the B gro up after make the operation of Posterior Osteosynthesis of the Atlas.There was significant statistical difference between A and B group(P<0.05),and also have significant statistical difference between A group and control g roup(P<0.05).But there was no statistical difference between B group and control group(P>0.05).Six months after operation,all fractures were achi eved bony Union,there were no internal fixation of fracture crack and fall off,and the pain from neck and shoulder disappeared.Significant statistical difference were observed in VAS visual score between group A and B.The frankel classification can recover to E,and the the range of cervical spine motion almost normal.Conclusion Posterior Osteosynthesis of the Atlas in the treatment w-ith Atlas fracture can recover the height of occipito-atlanto-axial comple x and keep good activity of the cervical vertebra,it can receive a better clinical efficacy.