Improvement in JOA score of treatment for complex atlas-axis fractures

Objective: The aim of this study was to explore the role of treatment for complex Atlas-Axis fractures, and compare the JOA score of surgical and conservation methods.Methodology: From June 2008 to May 2012, 33 patients suffering from Atlas-Axis fracture were included in our study. Fifteen patients received posterior cervical pedicle screw fixation, and 18 patients received the conservation treatment. All the patients were followed up for 12 months after discharge. Results: The mean operative time was about 128 minutes (ranged: 92 to 165 minutes), the mean hospital stay time was 15.5 days (ranged: 8-21 days), and the mean follow-up of all the patients was 27months (ranged: 7 to 43 months). All patients gained a solid fusion, and no one showed any disability at the end of the follow-up. The JOA scores before treatment were 6.4±0.3 and 7.1±0.4 before and after treatment, and they significantly increased to 13.8±0.8 and 13.7±0.9 when following up for 12 months (P 0.05). Conclusions: Posterior cervical pedicle screw fixation is a feasible, effective and safe method for complex atlantoaxial fractures. This technique could achieve high JOA score, decreased blood loss and post-operative complications