Treatment strategy of unstable atlas fracture: A retrospective study of 21 patients

Medicine, 2020 · DOI: http://dx.doi.org/10.1097/MD.0000000000020153 · Published: May 1, 2020

Simple Explanation

The study introduces a novel surgical technique for treating unstable atlas fractures, which are rare and dangerous injuries to the topmost vertebra in the neck. The technique involves using a towel clamp to stabilize the fractured vertebra during screw placement. Traditional methods can be challenging due to the instability of the fractured bone, sometimes forcing surgeons to perform more extensive fusions. The new method aims to improve the accuracy and safety of screw insertion, potentially avoiding these complications. The study followed 21 patients who underwent this procedure, assessing bone fusion, spinal cord integrity, pain levels, and daily living activities. The results suggest that this technique is a safe and reliable alternative for treating unstable atlas fractures.

Study Duration

October 2012 to July 2017

Participants

21 patients with unstable atlas fracture

Evidence Level

Level 3, Retrospective Study

Key Findings

1
The use of a towel clamp to fix the lateral mass during posterior transpedicular fixation appears to be a safe and reliable method for treating unstable atlas fractures.
2
Patients experienced significant improvements in pain (VAS scores) and daily activities (NDI) following the procedure, with successful bone fusion observed in all cases.
3
The study reported no screw loosening or breakage, plate displacement, neurovascular injury, or severe complications during the follow-up period.

Research Summary

This study introduces a novel surgical technique using a towel clamp to stabilize the lateral mass during posterior transpedicular fixation for unstable atlas fractures. The results demonstrate significant improvements in patient outcomes, including reduced pain and improved daily function, with no major complications reported. The authors conclude that this method is a simple, safe, and reliable alternative for treating unstable atlas fractures, potentially avoiding the need for more extensive surgical procedures.

Practical Implications

Surgical Technique Improvement

The towel clamp method can be adopted by surgeons to improve the precision and safety of screw placement in unstable atlas fractures.

Patient Outcome Enhancement

The technique can lead to better patient outcomes, including reduced pain, improved function, and a lower risk of complications.

Reduced Need for Extensive Fusion

By stabilizing the fracture effectively, the technique may decrease the necessity for more invasive C0-C2 fusion surgeries.