The following is a summary of “Direct osteosynthesis in the treatment of Atlas burst fractures: a systematic review,” published in the February 2024 issue of Surgery by Niu et al.
The management of unstable atlas fractures remains a topic of debate within the medical community. This study aims to evaluate the prognosis and effectiveness of osteosynthesis in treating unstable atlas fractures by systematically reviewing the current literature. Additionally, it seeks to compare outcomes between the transoral and posterior approaches.
A systematic review was conducted using PubMed, EMBASE, Cochrane, Web of Science, CNKI, and Wanfang databases. Two reviewers screened titles and abstracts to identify studies meeting predefined inclusion criteria for comprehensive analysis.
The systematic review included 28 articles, with 19 employing the posterior approach and 9 utilizing the transoral approach. The analysis revealed favorable healing rates and clinical improvement by encompassing 297 patients with unstable atlas fractures, of which 169 were treated via the posterior approach and 128 via the transoral approach. Post-surgery, improvements were observed in various parameters, including the visual analog scale, range of motion, atlantodens interval, and lateral displacement distance.
Osteosynthesis demonstrates efficacy in treating unstable atlas fractures, with both transoral and posterior approaches yielding positive clinical outcomes. Biomechanical studies have confirmed the ability of osteosynthesis to maintain stability in the occipitocervical region and preserve motor function in the atlantoaxial and occipital-atlantoaxial joints, thereby enhancing patients’ quality of life. However, differences exist in the indications and surgical risks associated with each approach, underscoring the importance of selecting the appropriate method based on a thorough clinical evaluation of the patient’s condition.
Source: josr-online.biomedcentral.com/articles/10.1186/s13018-024-04571-9
