masterThesis
Tratamiento de fracturas atlantoaxiales combinadas en el adulto mayor empleando instrumentación posterior tornillo-barra C1-C2
Autor
Vergara-Garcia, David
Buriticá, José L.
Torres, Jorge
Laverde, Leonardo
Institución
Resumen
Introduction: Since C1-C2 posterior screw-rod instrumentation has shown good postoperative results in different types of pathologies with atlantoaxial instability independent of age, it is reasonable to think about its potential applicability in the scenario of combined atlantoaxial fractures in elderly patients, for whom surgical management has proven beneficial. Objective: To perform a retrospective description of the postoperative results obtained in elderly patients with combined atlantoaxial fractures brought to surgical management with C1-C2 posterior screw-rod instrumentation. Materials and Methods: Medical records of patients older than 65 years admitted to two hospitals in the city of Bogotá DC from January 2016 to January 2017, diagnosed with combined acute traumatic fractures of the atlas and the axis, taken to later C1-C2 posterior screw-rod instrumentation were reviewed. Demographic and clinical data, type of fractures, neurological status, pain status, bone fusion status, among others, were collected. Results: Seven male patients were obtained, with an average age of 72.3 years. None presented perioperative complications or postoperative neurological deterioration. Bone fusion and stability of the construct were evidenced in 100% of the patients a year after surgery, with complete resolution of cervical pain in 5 individuals, and partial resolution in the remaining two. Conclusions: C1-C2 posterior screw-rod instrumentation is an excellent option for the surgical management of elderly patients with combined atlantoaxial fractures given its low rate of complications and high rate of bone fusion.