Table 1 Report of posterior internal fixation approach osteosynthesis for atlas fracture
From: Direct osteosynthesis in the treatment of atlas burst fractures: a systematic review
Study/publication year | Study design | Level of evidence | Country | Age (years) | Number of patients | Gender (M/F) | Surgical time (min)/Follow-up (mo) | Blood loss (mL) | Implant | Fracture type |
|---|---|---|---|---|---|---|---|---|---|---|
Li et al. [21] | Case report | IV | China | 33 | 2 | 1/1 | NA/12 | NA | Screws + rod | Jefferson fracture |
Jo et al. [30]/2011 | Case report | IV | Korea | 31 | 1 | 1/0 | NA/8 | NA | Screws + rod | Jefferson fracture |
Abeloos et al. [20] | Case report | IV | Belgium | 25 | 1 | 1/0 | NA/7 | NA | Polyaxial screws + rod | Landells: type II |
Bransford et al. [31] | Case series | IV | USA | 54.3 | 3 | 3/0 | NA/14.5 | NA | Polyaxial screws + rod | NA |
Hu et al. [19] | Retro study | II | China | 35.6(20–60) | 12 | 8/4 | 70.5/22 | 150(100–300) | Polyaxial screws + rod | Landells: type II |
He et al. [14] | Retro study | II | China | 43.5(23–68) | 22 | 16/6 | 86(68–122)/22.56 ± 18.0(12–32) | 120(90–400) | Polyaxial screws + plate | NA |
Shatsky et al. [13] | Retro study | II | USA | 43 (21–86) | 12 | 9/3 | NA/17 | NA | Polyaxial screws + rod | Landells: type II |
Gumpert et al. [22] | Case series | IV | Australia | 50.7 | 3 | 2/1 | NA/NA | NA | Monoaxial screws + rod | Landells: type II (1); type III (2) |
Ottenbacher et al. [32] | Case report | IV | Australia | 70 | 1 | 1/0 | NA/NA | NA | Polyaxial screws + rod | Jefferson fracture |
Gelinas-Phaneuf et al. [28] | Retro study | II | USA | 37.9(20–71) | 8 | 6/2 | NA/12.6(1–49) | NA | Polyaxial screws + rod Monoaxial screws + rod | NA |
Zhang et al. [7] | Retro study | II | China | 50.3 | 9 | 6/3 | 127/17.4 | 106 | Monoaxial screws + rod | Landells: type II (7); type III (2) |
Kumar et al. [33] | Case report | IV | Singapore, Australia | 39 | 1 | 1/0 | NA/12 | NA | Screws + rod | NA |
Li et al. [34] | Retro study | II | China | 36.7(18–57) | 25 | 19/6 | 76(80–120)/41(6–72) | 150(100–300) | Screws + plate | NA |
Rajasekaran et al. [35] | Prospe study | II | India | 39.6 | 5 | NA | 77 ± 13.96/40.8(25–59) | 84.4 ± 8.04 | Polyaxial screws + rod | NA |
Gao et al. [36] | Retro study | II | China | 38.5 ± 11.3 | 23 | 15/8 | 93.6 ± 28.1/15.3 ± 8.5 | 158.5 ± 53.6 | Monoaxial screws + rod | Landells: type II |
Shin et al. [29] | Retro study | II | Korea | 37 (21–63) | 12 | 8/4 | 111.92 ± 7.14/12 | 125 ± 78.33 | Polyaxial screws + rod | 4-part atlas fracture: 3 lateral mass fractures: 9 |
Ottenbacher et al. [37] | Case series | IV | Germany | 60.8 | 5 | 4/1 | 116.8/11.6 | 480 | NA | NA |
Bao et al. [38] | Retro study | II | China | 51.8 | 14 | 10/4 | 82.1 ± 8.8/21.0 ± 6.4 | 84.3 ± 16.8 | Screws + rod | NA |
Yang et al. [23] | Retro study | II | China | 47.0 ± 9.7 | 10 | 9/1 | 108.7 ± 20.1/16.7 ± 9.6 | 98.0 ± 41.3 | Screws + plate | Landells: type II (7); type III (3) |
Study | VAS(preoperative-last follow-up) | ROM(°) | ADI(mm) | LMD(preoperative-postoperative)(mm) | TAL injury | infection rate, n (%) | Complications | Fusion (bone consolidation/ healing)/Clinical improvement, n (%) |
|---|---|---|---|---|---|---|---|---|
Li et al. [21] | NA | NA | NA | NA | NA | NA | NA | 2(100)/NA |
Jo et al. [30]/2011 | NA | NA | NA | NA | 0(0) | NA | NA | 1(100)/1(100) |
Abeloos et al. [20] | NA | NA | NA | NA | NA | NA | NA | 1(100)/NA |
Bransford et al. [31] | NA | NA | NA | NA | 0(0) | NA | Suboptimally placed right C1 lateral mass screw:1(33) | 3(100)/NA |
Hu et al. [19] | 7.52 ± 3.2(6–10) to 1.80 ± 2.12(0–4) | 36(27–41)flexion; 40(30–49)extension; 32(16–38)left bending;29(14–37) right bending;62(36–75) rotation of C1–C2 | 2.4(2.0–3.0)flexion;1.6(1.0–2.0)extension | 7.5 (5–13) to 3.0(1–6.0) | 5(42) | NA | Partial breach of the pedicle screw:1(8.3);screw displacement:1(8.3) | 12(100)/NA |
He et al. [14] | 7.26 ± 1.4(4–8) to 1.96 ± 1.1(0–3) | Axial:42.4 ± 11.0(28.6–63.5) | NA | NA | 22(100) | NA | NO | 22(100)/22(100) |
Shatsky et al. [13] | 0.7 ± 1.6 at last follow-up | NA | ADI ≤ 4 at last follow-up | 7.1 to 2.1 | 11(92) | NO | Errant lateral mass screw placement: 1 (8.3); Occipital-C1 arthrosis:1 (8.3) | 12(100)/NA |
Gumpert et al. [22] | NA | 45–90 left rotation; 45–70 right rotation | NA | NA | 1(33) | NA | Screw penetrated into the spinal canal:1(33) | 3(100)/NA |
Ottenbacher et al. [32] | NA | 38/0/32 degree rotation of the head | less than 3Â mm | NA | 1(100) | NA | NA | NA/NA |
Gelinas-Phaneuf et al. [28] | 5.1 to 0.8 | Two patients had decreased ROM | NA | NA | NA | NO | Transient neurological deficit due to vertebral artery dissection:1(13) Lucency around a screw:1(13) | 6(75)/7(88) |
Zhang et al. [7] | 1.0 ± 0.87(0–2) | All the patients had a well-preserved ROM | 3.2;more than 4 mm:3(33) | 7.0 ± 2.2 to restored completely | 8(89) | NO | NO | 9(100)/NA |
Kumar et al. [33] | NA | NA | NA | NA | NA | NA | NA | 1(100)/1(100) |
Li et al. [34] | 6.8 ± 1.5 to 1.6 ± 0.2 | NA | NA | 4.35 ± 2.03 to 1.35 ± 1.13 | NA | NA | Screw breaks through pedicle bone cortex:1(4) | NA/NA |
Rajasekaran et al. [35] | NA | 35.4 flexion;43.8 extension;24.8 left bending;28.4 right bending;71.6 left rotation;73.6 right rotation | NA | 14.6 ± 1.34 to 5.2 ± 1.64 | NA | NA | NO | 5(100)/5(100) |
Gao et al. [36] | 7.2 ± 1.8 to 1.5 ± 1.1 | NA | NA | 7.3 ± 2.1 to 0.7 ± 0.5 | 18(78) | 2(9) | NA | 23(100)/NA |
Shin et al. [29] | 0.92 ± 0.99 (0–3) | 36.17 ± 5.42 (27–41) flexion;40 ± 5.79 (30–45)extension;75.83 ± 3.59 (70–80) rotation | 3.79 ± 1.56 postoperative extension;3.13 ± 1.01 postoperative flexion;3.42 ± 1.34 postoperative 6 months;3.33 ± 1.24 postoperative 1 year | NA | 12(100) | NO | NA | 11(92)/NA |
Ottenbacher et al. [37] | NA | NA | 2.25 flexion;1.5 extension | 5.16 to 2.14 right; 5.76 to 3.02 left | 5(100) | NA | NO | 5(100)/NA |
Bao et al. [38] | 6.5 ± 1.3 to 1.9 ± 0.8 | 79.7 ± 6.0 (70–88) flexion and extension; 82.1 ± 2.8 (76–85) left/right bending; 143.5 ± 8.4 (129–155) left/right rotation | NA | NA | NA | NO | NO | 5(100)/NA |
Yang et al. [23] | 0.6 ± 0.7 at last follow-up | All patients preserved almost full ROM | 2.3 ± 0.8 at last follow-up | 7.1 ± 1.9 to restored completely | 8(80) | NO | NO | 10(100)/10(100) |