gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Left-Right axial rotation within C1-C2 following implant removal

Meeting Abstract

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  • E. Salman - Wirbelsäulenchirurgie/Neurotraumatologie, SRH Klinikum Karlsbad Langensteinbach, Karlsbad
  • T. Pitzen - Wirbelsäulenchirurgie/Neurotraumatologie, SRH Klinikum Karlsbad Langensteinbach, Karlsbad
  • B. Boyaci - Wirbelsäulenchirurgie/Neurotraumatologie, SRH Klinikum Karlsbad Langensteinbach, Karlsbad
  • G. Ostrowski - Wirbelsäulenchirurgie/Neurotraumatologie, SRH Klinikum Karlsbad Langensteinbach, Karlsbad
  • T. Welk - Radiologie, SRH Klinikum Karlsbad Langensteinbach, Karlsbad
  • J. Harms - Wirbelsäulenchirurgie/Neurotraumatologie, SRH Klinikum Karlsbad Langensteinbach, Karlsbad

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 011

doi: 10.3205/12dgnc398, urn:nbn:de:0183-12dgnc3982

Published: June 4, 2012

© 2012 Salman et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Within the human spine the atlantoaxial joint is the most mobile one, especially important for left-right axial rotation around the axis given by the odontoid process. Within the surgical armamentarium, the procedure according to F. Magerl was the standard procedure to fix the joint following for example atlantoaxial injuries. Unfortunately, this procedure completely stops motility within the joint permanently. The posterior fixation according to Harms could be beneficial, because the screws do not cross the joint and – if there are removed – the joint still may be mobile. This, however, must not necessarily be true, especially if we notice that cervical joints have a tendency for rapid fusion after surgery. The objective of this study was to analyse

1.
left-right axial rotation following implant removal,
2.
a difference in motility depending on gender,
3.
a correlation of motility to age 4. a correlation of motility to the "implant-in-body-time" in patients having received a C1-C2 fixation acc,

to Harms after implant removal.

Methods: Retrospective study in 9 patients, having received atlantoaxial fixation according to Harms following atlantoaxial injury. Implant removal after a mean time of 128 days, followed by functional atlantoaxial computed tomography in left-right rotation. Statistical analysis using SPSS software package, significance assumed for p < 0.05.

Results: 1. Left-right axial rotation within the atlantoaxial joint was measured to be 17 ° (mean value) following implant removal. 2. There is no significant difference between men (20°) and women (14,8°), p = 0.595. 3. Left-right axial rotation negatively correlates to the age of the patient (r 0 -0.646, p 0 0.043) 4. "Implant-in-Body-Time" does not influence left-right axial rotation (r 0 0.04, p = 0.907) if the implants are removed within 90–180 days after surgery.

Conclusions: Removal of the implants 3–6 months after posterior atlantoaxial fixation acc. to Harms is beneficial for obtaining some axial rotation within the atlantoaxial joint. The range of motion preserved depends on the age of the patient.