P20. Posterior osteosynthesis with monoaxial lateral mass screw-rod system for unstable atlas fractures

Abstract

BACKGROUND CONTEXT

Atlas fractures pose a clinical challenge due to their impact on craniovertebral stability and the need to preserve cervical mobility. Traditional fixation methods, such as C1-C2 fusion, restrict motion, leading to long-term morbidity.

PURPOSE

To evaluate the efficacy of C1-ring osteosynthesis using a monoaxial lateral mass screw-rod system in stabilizing unstable atlas fractures while preserving cervical motion.

STUDY DESIGN/SETTING

Retrospective case series in a single-center hospital setting.

PATIENT SAMPLE

Three patients (ages 70-72, two males, one female) with unstable atlas fractures classified using the Jefferson classification.

OUTCOME MEASURES

Visual Analog Scale (VAS) for pain, atlanto-dental interval (ADI), C1 overhang, and cervical range of motion (ROM).

METHODS

All patients underwent C1-ring osteosynthesis with a monoaxial lateral mass screw-rod system. Pre- and postoperative assessments included pain scores, radiographic alignment, and ROM analysis. Follow-up was conducted to evaluate clinical outcomes and complications.

RESULTS

Postoperative pain scores improved significantly, with VAS decreasing from 5 to 0. Radiographic analysis confirmed successful reduction and stability, with ADI and C1 overhang restored within normal limits. ROM assessments indicated preserved cervical mobility. No major complications or reoperations were observed.

CONCLUSIONS

C1-ring osteosynthesis with a monoaxial lateral mass screw-rod system is a viable alternative to C1-C2 fusion, providing effective stabilization and pain relief while preserving cervical motion. This technique offers a promising surgical option for managing unstable atlas fractures with favorable clinical outcomes.

FDA Device/Drug Status

This abstract does not discuss or include any applicable devices or drugs.