The Journal of Bone and Joint Surgery, Vol 58, Issue 3 400-407, Copyright © 1976 by Journal of Bone and Joint Surgery, Inc
Spine fusion for atlanto-axial instability
JW Fielding, RJ Hawkins and SA Ratzan
A follow-up study was done on fifty-seven spine fusions for atlanto-axial
instability, classified as Type I - deficient odontoid (twenty-eight
patients), Type II - deficient ligaments (twenty-three patients), and Type
III - rotatory fixation (six patients). The average age of the patients at
the time of the fusion was thirty years, and half had had significant
trauma. Symptoms had been present for an average of 12.3 months before
fusion. Preoperatively pain was the predominant complaint in twenty-nine;
neurological complaints, in twenty-four; and instability in the rest. Of
the forty-six Gallie fusions, there was one non-union and of the eleven
occipitocervical fusions, two non-unions. Follow-up averaging 4.2 years
revealed resolution of symptoms in almost all patients.