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. 2018 May 7:9:94.
doi: 10.4103/sni.sni_10_18. eCollection 2018.

New technique for C1-C2 fixation

Ali Harati  1 , Rolf Schultheiß  1
Affiliations

New technique for C1-C2 fixation

Ali Harati et al. Surg Neurol Int. .

Abstract

Background: There are several techniques for treating atlantoaxial instability, including the Magerl transarticular screw fixation and the Harms/Goel C1-C2 screw rod techniques. Here, we present a novel technique utilizing a polyaxial screw rod system and a combination of C1 lateral mass and C1-C2 transarticular screws.

Methods: We retrospectively reviewed 14 patients (7 women, 7 men; mean age 62) who underwent surgery for type II odontoid fractures (n = 7), pseudarthrosis after anterior odontoid screw placement (n = 3), Os odontoideum (n = 2), atlantoaxial instability after C3-C5 fusion (n = 1), and craniovertebral rheumatoid arthritis (n = 1). Ten patients underwent posterior C1-C2 fixation, three patients with osteoporosis had C1-C4 fixation, and one patient had C1-Th1 fixation. The mean follow-up time was 22 months.

Results: Intraoperatively, there were no complications (e.g., vertebral artery, nerve root, or spinal cord injury). Postoperative imaging showed no screw malpositioning, and no screw loosening, fracture, or bone absorption around the screws. Furthermore, all patients exhibited postoperative improvement in neck pain.

Conclusions: C1 lateral mass and C1-C2 transarticular polyaxial screw rod fixation techniques were effective in achieving immediate rigid immobilization of the C1-C2 motion segment.

Keywords: Atlantoaxial instability; C1-C2 Fixation; craniocervical junction; odontoid fracture; os odontoideum.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic drawing showing posterior atlantoaxial fixation with combination of C1 lateral mass and C1-C2 transarticular screws using a polyaxial screw rod system
Figure 2
Figure 2
Postoperative sagittal CT-reconstructed view after atlantoaxial fixation with combination of C1 lateral mass and C1-C2 transarticular screws
Figure 3
Figure 3
(a) Preoperative sagittal CT-reconstructed view of a patient with dislocated odontoid fracture (Patient 1). (b) Postoperative lateral X-ray after complete reposition and posterior atlantoaxial fixation with combination of C1 lateral mass screws and C1-C2 transarticular screws (Patient 1)
See this image and copyright information in PMC

References

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