Atlantoaxial Fusion with Transarticular Screws: Meta-Analysis and Review of the Literature

Elliott, Robert E.; Tanweer, Omar; Boah, Akwasi; Morsi, Amr; Ma, Tracy; Frempong-Boadu, Anthony; Smith, Michael L.

doi:10.1016/j.wneu.2012.03.012

Cited by 52 publications

(42 citation statements)

References 43 publications

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“…A meta-analysis showed that the atlantoaxial transarticular screw technique contributes to a fusion rate as high as 94.6%, as well as a 0.2% incidence of neurologic injury, a 3.1% incidence of vertebral artery injury, and a 7.1% incidence of clinically significant malpositioned screws [24].…”

Section: Atlantoaxial Transarticular Screw Techniquementioning

confidence: 99%

Posterior atlantoaxial fixation: a review of all techniques

et al. 2015

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Section: Atlantoaxial Transarticular Screw Techniquementioning

confidence: 99%

Posterior atlantoaxial fixation: a review of all techniques

et al. 2015

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“…Currently, the literature only contains one metaanalysis examining this issue (10). In that meta-analysis of more than 2000 patients undergoing C1-2 transarticular screw fixation, the authors concluded that the procedure was safe with a 30-day perioperative mortality of 0.8%.…”

Section: Introductionmentioning

confidence: 99%

Risks of In-Hospital Death and Complications After Fusion Surgery in Patients with Atlantoaxial Subluxation: Analysis of 1090 Patients Using the Japanese Diagnosis Procedure Combination Database

et al. 2015

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“…The mean incidence of vertebral artery injury is lower with this method than that with Magerl's technique. 3,27,28 Screw malpositioning, compression of the vertebral artery, and sensory deficit due to C2 nerve root injury or dissection are the most commonly reported complications associated with Harms technique. 6,11,29 The C2 nerve root is not routinely dissected and ligated because this could lead to sensory deficit and risk for postoperative neuralgias, as confirmed by other studies in the literature.…”

Section: Discussionmentioning

confidence: 99%

C1-C2 Posterior Cervical Fixation by a Harms Technique Modification

Siasios¹,

Vakharia²,

Kowalski³

et al. 2017

The Journal of Spinal Surgery

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Introduction:The unique anatomy of the upper cervical spine in conjunction with its supportive role in the axial stabilization and rotatory function of the head increases the surgical risk and associated complications for corrective surgeries performed in this spinal region. C1-C2 posterior fixation is indicated in the occurrence of instability at the craniocervical junction; and it can be performed by specific surgical techniques, such as the Harms and Magerl techniques. In this technical note, the authors present a simplified modification of the Harms technique that increases the accuracy of screw placement in the lateral mass of the C1 vertebra and in the pedicle of the C2 vertebra. This modification provides a secure path for screw placement by obtaining fluoroscopic images of K-wires inserted in the lateral masses of C1 and the pedicles of C2 as in the original technique. According to this technique, a pin driver is used to guide a K-wire through the initially marked entry point to the lateral mass of C1. After fluoroscopic confirmation of the optimal position of the guide wire, a cannulated hand drill is placed over the guidewire. A pilot hole is drilled in the same trajectory for the screw placement under fluoroscopic control. Then the guidewire and the hand drill are removed and an appropriately sized 3.5 mm polyaxial screw is placed with a hand drill under confirmation of the correct position with anteroposterior and lateral fluoroscopy. The same procedure is followed for the placement of the C2 pedicle screws. Then, a small rod is placed and secured within the polyaxial screw heads of the C1 and C2 screws bilaterally. Decortication of the spinous processes of the involved vertebrae and the occiput is the final step before closure of the fascia, cervical muscle layer, subcutaneous tissue, and skin.

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Atlantoaxial Fusion with Transarticular Screws: Meta-Analysis and Review of the Literature

Cited by 52 publications

References 43 publications

Posterior atlantoaxial fixation: a review of all techniques

Posterior atlantoaxial fixation: a review of all techniques

Risks of In-Hospital Death and Complications After Fusion Surgery in Patients with Atlantoaxial Subluxation: Analysis of 1090 Patients Using the Japanese Diagnosis Procedure Combination Database

C1-C2 Posterior Cervical Fixation by a Harms Technique Modification

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