J Korean Soc Spine Surg.  2007 Sep;14(3):187-191. 10.4184/jkss.2007.14.3.187.

Revision of Atlantoaxial Fusion using Segmental Screw Fixation: Experience in Bilateral Posterior Arch Fracture of the Atlas Complicating Atlantoaxial Halifax Clamp Fixation: A Case Report

• Suh JS
• Kim KH
• Hong SW
• Yeom JS
• Park KW
• Chang BS
• Lee CK

• KMID: 1941651
• DOI: http://doi.org/10.4184/jkss.2007.14.3.187

Abstract

A fracture of the posterior arch of the atlas is a rare complication of Halifax clamp fixation for atlantoaxial fusion. To the best of our knowledge, there is only one case reported reporting the English literature. Revision for this condition is challenging because of the difficulty in the surgical approach, internal fixation, and fusion. We report a case of bilateral fractures and nonunion of the posterior arch of the atlas and atlantoaxial nonunion after an atlantoaxial fusion procedure using Halifax clamp fixation, which resulted in persistent atlantoaxial instability and progressive myelopathy. Segmental screw fixation was performed using C1 lateral mass screws and C2 subarticular screws, along with intraarticular and extraarticular atlantoaxial inter-facet fusion.

Keyword

Atlantoaxial instability; Halifax clamp; Segmental screw fixation; Revision

MeSH Terms

Spinal Cord Diseases