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Comparative study of craniocervi fusion vs.atlanto-axial fusion in treating subaxial cervical spine instability

FU Song,SHAO Shi-ze,LIU Hai-jun,et al.Department of Spine and Spinal Cord,Wendeng Hospital of Traditional Chinese Orthopedics and Traumatology of Shandong Province,Wendeng 264400,China  
Objective To investigate the clinical outcome and degeneration for the treatment of subaxial cervical spine instability with craniocervi fusion or atlanto-axial fusion.Methods From June 2004 to June 2008,33 patients with subaxial cervical spine instability treated with fusion and followed up for more than two years were reviewed retrospectively.All patients were divided into group A(craniocervi fusion) and B(atlanto-axial fusion) based on interbody fusion methods.JOA was used to evaluate the neurological symptoms,and the fusion status and degeneration of cervical spine were evaluated by X-ray.The clinical outcome and the range of motion(ROM) of cervical spine in the two groups were also compared.No significant difference was noted between two groups with respect to age,JOA,ROM of cervical spine and traction time preoperation.Results All operations were performed successfully.No surgery-related complications were noted after operation.The fusion status and JOA score showed no difference between two groups(P0.05).There were significant differences between two groups regarding to ROM of cervical spine(P0.05).Conclusion These two approaches had similar clinical outcomes to achieve a satisfactory bone graft fusion and neurological symptom relief.Compared to craniocervi fusion,atlanto-axial fusion had little influence on ROM and degeneration of cervical spine,which was the preferred surgical method for upper cervical spine instability.
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