Hook-plate instrument for C2 vertebral body disorders via submandiblar and retropharyngeal approach

English Keywords:Atlanto-axial joint  Odontoid vertebra  Arthrodesia  Hook－plate  Internal fixation

English Abstract:

  【Abstract】 Objective：To evaluate the clinical effect of hook－plate system on the treatment of C2 vertebral body disorders via submandiblar and retropharyngeal approach.Method：Thirteen patients with C2 vertebral body disorders undergoing hook－plate instrumentation and bone graft or cement placement were reviewed retrospectively.There were 4 C2 burst fracture（2 with C2/3 disc rupture and 2 with type Ⅱ and Ⅲ odontoid fracture），4 C2 tuberculosis，5 C2 tumor（2 benign and 3 malignant）.All patients presented with pain and malfunction of occipito-cervical region to various extent without any neurological deficits.Result：All operations were completed successfully，with the surgical time of 90 to 140min（mean，120min），blood loss of 200 to 1250ml（mean，380ml）.No neurovascular iniury was noted.2 cases were complicated with superior laryngeal nerve deficit after operation，which resolved followed by conservative intervention for 1 month.All skin incision were healed primarily.13 cases were followed up with the mean of 18 months（range，6-32 months），and 10 cases undergoing bony graft were evidenced bony union 4 months later（range，3-6 months）.No instrument failure was noted afterwards.Conclusion：Hook-plate instrument for C2 vertebral body disorders via submandiblar and retropharyngeal approach can perform debridement as well as stability reconstruction，which is reliable and less invasive.