• Yong-long Chi, Hua-zi Xu, Yan Lin, Qi-shan Huang, Fang-min Mao, Xiang-yang Wang, and Wen-fei Ni.
• Department of Orthopaedic, the Second Affiliated Hospital, Wenzhou Medical College, Wenzhou 325027, China. feygk@163.com
• Zhonghua Wai Ke Za Zhi. 2007 Mar 15;45(6):383-6.

ObjectiveTo evaluate the safety and efficacy of one-stage percutaneous microendoscopic anterior release, trans-articular fixation and fusion to reduce and stabilize for irreducible atlanto-axial dislocation.MethodsEight consecutive patients were treated by percutaneous microendoscopic anterior release, trans-articular C(1-2) fixation and bone graft fusion. The mean age was 33 years (range, 28-52 years). The pathology included odontoid dysplasia in 3 patients, chronic odontoid fractures in 2, odontoid absence in 1, fasilar impression in 1 and malunion of odontoid fracture in 1. The classification of disability was that proposed by Symon and Lavender. There were moderate disability in 4, severe non-bedbound in 3, and severe bedridden in 1.ResultsThe new technique was performed successfully in all cases. All patients underwent trans-articular C(1-2) screw fixation and anterior bone graft fusion. The average operation time was 120 min (90-150 min), and the average estimated blood loss was 150 ml (100-250 ml). Seven cases resulted in anatomic reduction, 1 had partial reduction. The follow-up period was 8-16 months. The effective rate was 100%, and the excellent rate was 51.25%; the average improvement rate for the spinal canal decompression was 76.5%. There was no instrument failure or pseudarthrosis, and solid fusion was achieved in the all cases. The loss of axial rotation of cervical spine was 30-40 degrees .ConclusionPercutaneous microendoscopic anterior release, fixation and fusion is an effective, reliable, and safe procedure for the treatment of irreducible atlanto-axial dislocation.

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