J Korean Neurosurg Soc.  2005 Mar;37(3):201-206.

The Results and Complications of the C1-C2 Transarticular Screw Fixation Methods

• Choi JW
• Yoon SH
• Park HC
• Park HS
• Kim EY
• Ha Y

Abstract

OBJECTIVE
To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. METHODS: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 pateints. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. RESULTS: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. CONCLUSION: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.

Keyword

Posterior C1-C2 transarticular screw fixation; C1-C2 instability; Rheumatoid arthritis; Os odontoideum; Psoriatic arthritis

MeSH Terms

Arthritis, Psoriatic
Arthritis, Rheumatoid
Humans
Ligaments
Odontoid Process
Retrospective Studies
Transplants
Vertebral Artery