Anterior reduction and C1-ring osteosynthesis with Jefferson-fracture reduction plate (JeRP) via transoral approach for unstable atlas fractures

Abstract Background To introduce a novel transoral instrumentation in the treatment of unstable fractures atlas. Methods From January 2008 to May 2018, 22 patients with C1 who received Jefferson-fracture reduction plate (JeRP) via approach were retrospectively analyzed. The case history and radiographs before after surgery noted. type fracture, position internal fixation assessed through preoperative postoperative CT scans. Results All successfully underwent anterior C1-ring osteosynthesis using JeRP system, follow-up 26.84 ± 9.23 months. Among them, 9 had transverse atlantal ligament (TAL) injury, including 3 Dickman I 6 II. lateral mass displacement (LMD) decreased from 7.13 1.46 mm 1.02 0.65 operation. Bone union was achieved all without implant failure or loss reduction. There no surgery-related complications, such as wound infection, neurological deficit, vertebral artery injury. However, atlantoaxial dislocation occurred TAL injury months postoperatively any symptoms neck pain. Conclusions Transoral is an effective surgical strategy treat atlas safe, direct, satisfactory primary indication for system fracture (Gehweiler I/III) or/ (Dickman II).