Acute combination fracture of atlas and axis: “triple” anterior screw fixation in a 92-year-old man

Agrillo, Umberto; Mastronardi, Luciano

doi:10.1016/j.surneu.2005.04.043

Cited by 24 publications

(31 citation statements)

References 23 publications

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“…When feasible, it ensures early maximal stability, even if it slightly reduces the mobility of C1-C2 complex. 1 We apply this technique through two small cervical incisions, which differs from that of Apostolides et al, 2 who described a single approach through which three screws were placed. Lots of reports have described the technique clinically and anatomically and mentioned the rare, if any, damage to the vertebral artery.…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive technique of triple anterior screw fixation for an acute combination atlas–axis fracture: case report and literature review

et al. 2009

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Study design: A case report to describe the minimally invasive technique of treating C1-type II odontoid combination fractures. Objective: To introduce a new, minimally invasive technique of triple anterior screw fixation for acute combination atlas-axis fractures. Summary of background data: Management for C1-type II odontoid combination fractures includes traction, immobilization and posterior fusion with and without instrumentation and anterior odontoid screw fixation. The combination of odontoid and bilateral transarticular C1-C2 anterior screw fixation is a recent addition in treating C1-type II odontoid fractures. Methods: A case of combination atlas-type II odontoid fracture occurred in a 39-year-old man. Imaging examinations showed a fracture of the unilateral anterior and posterior arch of C1 associated with type II odontoid fracture and with significant prevertebral soft tissue edema. Treatment consisted of odontoid and bilateral C1-C2 transarticular screw fixation through bilateral anterior small incisions. Results: The patient was mobilized early postoperatively with a hard cervical collar and discharged 4 days later. On 2-year follow-up, he presented no cervical complaints and only mild reduction in neck rotation. Conclusion: In case of C1-type II odontoid fracture, the triple anterior screw fixation can be taken into consideration as an alternative because of its superiority of minimal invasion, stability and safety.

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Section: Discussionmentioning

confidence: 99%

“…There have been two reports of 92-and 85-year-old men with 'triple' anterior screw fixation technique. 1,2 We report the successful result obtained in a young patient affected by an acute combination atlas-type II odontoid fracture and treated with anterior odontoid and bilateral C1-C2 transarticular screw fixation.…”

Section: Introductionmentioning

confidence: 98%

Minimally invasive technique of triple anterior screw fixation for an acute combination atlas–axis fracture: case report and literature review

et al. 2009

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“…Anterior transarticular screw (ATAS) fixation across the atlantoaxial joint has been suggested as a viable alternative to posterior stabilization in the upper cervical spine [1][2][3][4][5][6][7][8][9][10]. Fixation through the anterior route may be advantageous in some patients requiring subsequent stabilization after anterior decompression because it obviates the need for additional posterior surgery [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…It may also be used as a complementary option if previous posterior fixation and fusion have failed to provide adequate stability [1,18]. Furthermore, it may be a reasonable option in selected cases in polytrauma, respiratory-compromised [4], or hemodynamically vulnerable elderly patients [5,6], wherein a prone position may increase operative morbidity and/or mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Since the introduction of this procedure [9,10], clinical studies have reported that this procedure has favorable early clinical outcomes [1,7] with high fusion rates [1][2][3]8], only minor complications [1][2][3]5], and less anatomic risk for the vertebral artery compared with posterior transarticular screws [16]. Several studies have also shown that the biomechanical properties of ATAS are comparable to posterior fixation techniques such as posterior transarticular screws [19] and posterior C1 lateral mass screw combined with C2 pedicle screw/rod systems [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Fluoroscopically guided anterior atlantoaxial transarticular screws: a feasibility and trajectory study using CT-based simulation software

et al. 2013

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BACKGROUND CONTEXT: Anterior transarticular screw (ATAS) fixation has been suggested as a viable alternative to posterior stabilization. However, we are not aware of previous reports attempting to establish the usefulness of specific fluoroscopic landmark-guided trajectories in the use of ATAS, and we could find no reference to it in a computerized search using MEDLINE. PURPOSE: To determine the anatomic feasibility of ATAS placement using defined fluoroscopic landmarks to guide screw trajectory. STUDY DESIGN: Evaluation using three-dimensional screw insertion simulation software and 1.0-mm-interval computed tomographic scans. PATIENT SAMPLE: Computed tomographic scans of 100 patients including 50 men and 50 women. OUTCOME MEASURES: Incidence of violation of the vertebral artery groove of C1 and C2, the spinal canal, and the atlanto-occipital joint and screw lengths and lengths of C1 and C2 purchase. METHODS: Four screw trajectories were determined: promontory screw (PS), single central facet (CF) screw, and medial (MF) and lateral (LF) double facet screws. Placement of a 4.0-mm screw was simulated using defined fluoroscopic landmarks for each trajectory. The previously mentioned outcome measures were evaluated and compared for the four trajectories. This study was not supported by any financial sources, and there is no topic-specific potential conflict of interest with this study. The disclosure key can be found on the CONCLUSIONS:Our results suggest that it may be possible to place ATASs without violating the vertebral artery groove, spinal canal, or the atlanto-occipital joint by using the described entry points, trajectories, and fluoroscopic landmarks. Ó

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Multiple Fractures of Axis and Atlas-Axis Fracture Combinations

Suchomel

Hradil

2010

Reconstruction of Upper Cervical Spine and Craniovertebral Junction

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Acute combination fracture of atlas and axis: “triple” anterior screw fixation in a 92-year-old man

Cited by 24 publications

References 23 publications

Minimally invasive technique of triple anterior screw fixation for an acute combination atlas–axis fracture: case report and literature review

Minimally invasive technique of triple anterior screw fixation for an acute combination atlas–axis fracture: case report and literature review

Fluoroscopically guided anterior atlantoaxial transarticular screws: a feasibility and trajectory study using CT-based simulation software

Multiple Fractures of Axis and Atlas-Axis Fracture Combinations

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