ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT MẤT VỮNG C1-C2 DO CHẤN THƯƠNG TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: The Harms technique using polyaxial screw fixation of the C1 lateral mass and C2 pedicle is considered an appropriate option for patients with traumatic C1-C2 instability, as it carries a low risk of vertebral artery injury and allows effective reduction and stabilization of the atlantoaxial complex. However, further studies are needed to evaluate the surgical outcomes of this technique. Objectives: To evaluate the surgical outcomes of traumatic C1 - C2 instability treated at Cho Ray Hospital. Methods: A retrospective descriptive case series was conducted on patients with traumatic C1- C2 instability who underwent C1 lateral mass and C2 pedicle screw fixation at Cho Ray Hospital between January 2019 and March 2022. Results: A total of 56 patients met the inclusion criteria, with a mean age of 38.63 ± 16.32 years. The mean operative time was 140 ± 30.15 minutes, and the average intraoperative blood loss was 200 ± 125.12 mL. Postoperative evaluations at 3 and 6 months demonstrated significant improvement in motor function, sensory function, and sphincter control, as well as neurological recovery according to the ASIA impairment scale compared with preoperative status. Adequate C1- C2 reduction was achieved, and the bone fusion rate was 92.85%. Conclusions: This study demonstrates that surgical treatment using polyaxial screw fixation of the C1 lateral mass and C2 pedicle provides favorable neurological recovery at 3 and 6 months postoperatively, with a high bone fusion rate in patients with traumatic C1 - C2 instability