Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (9): 1594-1598.doi: 10.3969/j.issn.1673-8225.2011.09.018

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Effect of cobra internal fixation system combined with halo-vest on treatment of the craniocervical malformation

Guo Liang-bing, Liao Wen-sheng, Wang Li-min, Wang Wei-dong, Tan Hong-yu, Bao Heng, Liu Yi-lin, Dong Xiao-tong   

  1. Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou  450052, Henan Province, China
  • Received:2010-10-06 Revised:2010-12-14 Online:2011-02-26 Published:2011-02-26
  • Contact: Liao Wen-sheng, Doctor, Associate professor, Associate chief physician, Master’s supervisor, Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China hnzzlws@hotmail.com
  • About author:Guo Liang-bing★, Studying for master’s degree, Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China benjoye@yahoo.cn

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Abstract:

BACKGROUND: Craniocervical posterior fusion can decompress the spinal cord and obtain the early stability for the instability occipitocervical fusion. The anatomic design of Cobra system can provid strongly internal fixation for this instability fusion and it is beneficial for fixation, reduction and bone graft fusion with the Halo-vest external fixation.
OBJECTIVE: To evaluate the clinical application of Cobra internal fixation system with Halo-vest in craniocervical fusion surgery for craniocervical region malformation patients.
METHODS: Thirty-four cases of craniocervical region malformation underwent craniocervical fusion using Cobra internal fixation system and with a specific therapy used Halo-vest according to the actual situation. The JOA17 spinal cord function evaluation standard was used for evaluation of the treatment effect. The neurologic recovery rate was calculated by the method established by Yin Qing-shui. At 3, 6, 12, and 24 months after the internal fixation, two-plane roentgenograms, CT and 3D reconstruction could be made to judge the internal fixation and bone grafting fusion situation, some patient also did MRI to clarify the spinal cord decompression.
RESULT AND CONCLUSION: All of the patients were followed up for 7-29 months. There were no aggravations of the symptoms of spinal cord compression. The preoperative average spinal function was 8.2 and postoperative average was 14.8, respectively. The overall mean improvement was 75%. One patient died of cerebral infarction postoperatively. At the sixth month of follow-up, there were two cases with bone graft nonunions and absorption, two cases with the loosed occiput plate bolt, one case with the pulled out screws, one case with a nonhealing incision. The Halo-vest was used in ten cases for 3 to 4 months postoperatively. Other cases wore a cervical collar until the bone grafts were fused completely. It is suggested that Cobra internal fixation system offers a good biomechanical stability for craniocervical region fixation. It’s convenient for reduction and fixation during the operation along with the Halo-vest, and suitable for the treatment of craniocervical region malformation.

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