Are C2 pars-pedicle screws alone for XXXX overrated?

@entity1 @entity717 @entity4049 @entity174
BACKGROUND/OBJECT: The recent trend for treatment of certain cases of @entity174 has been towards motion preserving surgery. This is claimed to be achieved with placement of pedicle screws across the @entity174 fragments. However, the long term outcome in clinical scenario is not yet clear, neither are the factors determining suitability of such a technique. MATERIALS AND METHODS: We have retrospectively analyzed the results of 11 @entity1 of @entity174 , according to the extent of translation. Nine @entity1 underwent stabilization of @entity174 with C2 pedicle screws and 2 were managed with halo immobilization. The conservative management failed in one and this @entity1 underwent internal fixation using pars-pedicle screw as well. The long term clinical and radiological (CT and dynamic X-rays) outcome was analyzed. RESULTS: All @entity1 including the one with halo immobilization, showed solid fusion across the @entity174 fragments. With the exception of one @entity1 none had any clinical symptoms. This lone @entity1 complained of @entity717 . Three different types of radiological results were observed. Two @entity1 with translation >8mm showed @entity4049 body fusion. Three of 6 @entity1 with minimal translational (3-4mm) showed facet fusion. Three @entity1 with moderate translational dislocation (4.5-5.5mm) showed persisting @entity4049 angular instability. CONCLUSIONS: The C2 pedicle screw is a good technique for osteosynthesis. However, the claimed long term advantage of motion segment preservation with this technique remains doubtful. It may be suitable for those @entity174 with minimal translation (<4mm), where the superiority of surgery, itself, over external immobilization is questionable. @entity4049 fusion is preferable for those @entity174 with translation >4mm as these are unstable and C2 pedicle screws alone are likely to have less desirable results.
