Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/286: 228-231

SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN ENGLISH.

Assessment of the results of occipito-cervical stabilization in cranio-vertebral damage

Rybarczyk M, Baranowska A, Baranowski P.

Department of Neurorthopedics, Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland

Damage to the cranio-vertebral junction includes bone and ligament structures as well as the nervous system. Due to the unique structure of the occipital-atlanto-axial complex (C0-C1-C2) and biomechanical properties, they cause a surgical challenge.
The aim of the surgery is to achieve bone fusion and stability of occipital-atlanto-axial complex. The aim of the study was to analyze the causes and effects of damage to the cranio-vertebral junction and the results of surgery with occipitocervical stabilization.
Material and methods. 43 patients who underwent occipital-cervical stabilization due to traumatic lesions in the C0-C1-C2 area were analyzed retrospectively in the 2000-2018 period in the Department of Neuroortopedia MCR STOCER.
Results. In 49%, the cause of trauma to the cranio-vertebral junction was a fall from a height, and it was in 37% a traffic accident. 70 % patients had C2 vertebra fracture with no stenosis of cervical canal and 14% had signs of C1-C2 instability. Politrauma was diagnosed in 9 patients and 23.3% of examined manifested neurological deficits. 70% of patients were in the 2nd group of risk according to the ASA scale.
Conclusions. The analysis of damage to the cranio-vertebral junction showed that the main cause of injury was a fall. 21% patients presented tetraparesis. When qualifying patients after trauma to the craniovertebral junction for surgery, the degree of risk should be taken into account. Despite the high complication rate which was over 50 %, presented technique was effective because 95% patient achieved bone fusion and stability C0-C1-C2 complex.

Key words: cranio-vertebral junction, occipital-cervical stabilization, dens fracture, C1-C2 instability

Pol Med J, 2020; XLVIII (286); 228–231