J Korean Neurosurg Soc.  1997 Sep;26(9):1231-1236.

Posterior C1-2 Transarticular Screw Fixation in Atlantoaxial Instability

Affiliations
  • 1Department of Neurosurgery, College of Medicine, Kyungpook University, Taegu, Korea.

Abstract

Posterior transarticular screw fixation is known to be one of the best surgical method for the atlanto-axial instability. Between April 1995 and February 1997, this technique was used in the treatment of 21 patients(10 men, 11 women) suffering from this condition. The average age at the time of operation was 39 years(range, 17 to 63). and mean follow-up period was 14(mean 3 to 25) months. The indication for fusion were nine cases, type II-A odontoid process fracture; three cases, type II-P odontoid process fracture; three cases, os odontoideum; three cases transverse ligament laxity due to rheumatoid disease; and three cases, transverse ligament injury without bone fracture. Eleven operations involved cases were operated with posterior C1, 2 transarticular screw fixation using a 3.5 mm cortical screw augmented th interlaminar iliac graft and sublaminar wire fixation. The other ten patients underwent the same surgery without sublaminar wire fixation. In two cases d screw were misplaced; one was placed lateromedially and the other caused widening of the joint capsule space, but there were corrected by reoperation. Patients were ambulated with Philadelphia neck collar on the first post-operation day. At the end of three months follow-up, bone union was seen in all cases, and the following conclusions may be drawn: 1) Immediately after surgery, ambulation is possible; 2) The rate of occurrence of bone union is high; 3) A halo vest is not needed; 4) Sublaminar wiring is also unnecessary.

Keyword

Atlantoaxial instability; Posterior transarticular screw fixation; Posterior wiring; Cervical spine

MeSH Terms

Follow-Up Studies
Fractures, Bone
Humans
Joint Capsule
Ligaments
Male
Neck
Odontoid Process
Reoperation
Transplants
Walking
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