Atlantoaxial instability treated with transarticular screw fixation

Naseer, Rizwan; Si, Bailey

doi:10.1007/s002640100258

Cited by 6 publications

(2 citation statements)

References 15 publications

(19 reference statements)

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“…3,19 One study of 12 SRC patients 25 and 4 studies comprising 74 TAS patients were performed in a prospective observational manner. 4,5,8,10,[13][14][15][16][17][18][20][21][22][23][24][26][27][28][29][30][31][32][33][34][35][37][38][39][40][41][43][44][45][46][47][48][49][50][51][52][54][55][56][57][58][59][60][61][62][63]…”

Section: Resultsmentioning

confidence: 99%

Outcome Comparison of Atlantoaxial Fusion With Transarticular Screws and Screw-Rod Constructs

Elliott¹,

Tanweer

Boah

et al. 2014

Journal of Spinal Disorders &Amp; Techniques

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TAS and SRC are safe and effective treatment options for C1-C2 instability but require a thorough knowledge of atlantoaxial anatomy for successful insertion of screws. Slightly higher rates of fusion and less risk of injury to the vertebral artery during screw placement were observed with the SRC technique. However, differences in graft material and techniques were noted. Prospective, randomized studies with validated radiographic and clinical outcome metrics are necessary for proper comparison of these techniques.

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Section: Resultsmentioning

confidence: 99%

Outcome Comparison of Atlantoaxial Fusion With Transarticular Screws and Screw-Rod Constructs

Elliott¹,

Tanweer

Boah

et al. 2014

Journal of Spinal Disorders &Amp; Techniques

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“…The purpose of surgery is to relieve nerve compression and restore the stability of the C1-2 joint. However, surgical decompression can aggravate AAI, which is commonly treated with standard posterior wires, 3 transarticular C1-2 screws, 19 C-1 lateral mass screws, 6 and plate internal fixation. 11 All of these operations can improve the stability of C1-2; however, C1-2 fusion may result in loss of ROM in all directions and adversely impact patient quality of life.…”

Section: Discussionmentioning

confidence: 99%

Novel posterior artificial atlanto-odontoid joint for atlantoaxial instability: a biomechanical study

Shen

Deng

Yang

et al. 2018

Journal of Neurosurgery: Spine

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OBJECTIVEAtlantoaxial instability is usually corrected by anterior and/or posterior C1–2 fusion. However, fusion can lead to considerable loss of movement at the C1–2 level, which can adversely impact a patient’s quality of life. In this study, the authors investigated the stability and function of a novel posterior artificial atlanto-odontoid joint (NPAAJ) by using cadaveric cervical spines.METHODSThe Oc–C7 regions from 10 cadaveric spines were used for anteroposterior (AP) translation and range of motion (ROM) tests while intact and after destabilization, NPAAJ implantation, and double-rod fixation.RESULTSThe mean AP C1–2 translational distances in the intact, destabilization, and double-rod groups were 6.53 ± 1.07 mm, 11.54 ± 1.59 mm, and 3.24 ± 0.99 mm, respectively, and the AP translational distance in the NPAAJ group was significantly different from that in the intact group (p < 0.05). The AP translational distance in the NPAAJ group was not significantly different from that in the double-rod group (p = 0.24). The mean flexion, extension, and axial rotation ROM values of the NPAAJ group were 9.87° ± 0.91°, 8.75° ± 0.99°, and 61.93° ± 2.93°, respectively, and these were lower than the corresponding values in the intact group (p < 0.05). The mean lateral bending ROM in the NPAAJ group (9.26° ± 0.86°) was not significantly different from that in the intact group (p = 0.23), and the flexion, extension, and rotation ranges in the NPAAJ group were 79.5%, 85.2%, and 82.3%, respectively, of those in the intact group.CONCLUSIONSUse of NPAAJ for correction of atlantoaxial instability disorders caused by congenital odontoid dysplasia, odontoid fracture nonunion, and C-1 transverse ligament disruption (IA, IB, and IIB) may restore the stability and preserve most of the ROM of C1–2. Additionally, the NPAAJ may prevent soft tissue from embedding within the joint. However, additional studies should be performed before the NPAAJ is used clinically.

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Potential intraoperative factors of screw-related complications following posterior transarticular C1–C2 fixation: a systematic review and meta-analysis

et al. 2018

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Purpose This study aimed to evaluate the impact of several factors, including patients' intraoperative position, intraoperative visualization technique, fixation method, and type of screws and their parameters, on the frequency of intraoperative screw-associated complications in posterior transarticular C1-C2 fixation. Methods A systematic review of the PubMed database between January 1986 and March 2018 was performed. The key inclusion criteria comprised detailed descriptions of the surgical technique and post-operative screw-associated complications. Results The initial search resulted in 1041 abstracts, and a total of 54 abstracts were included in the present study. The overall number of operated patients was 2306. In this group, 4439 screws were inserted. The rate of screw-associated complications during the different time periods was estimated upon meta-analysis. Statistical analysis of the screw malposition rate, vertebral artery injury rate, screw breakage rate based on patients' intraoperative position, intraoperative visualization technique, fixation method, and type of implants and their parameters was also performed. Conclusions The factors that help reduce the rate of screw-associated complications include the intraoperative application of biplanar fluoroscopy or neuronavigation system, the use of 4 mm or thicker lag screws, and screw insertion through contraincisions using cannulated ported instruments. On the other hand, the potential risk factors of screw-associated complications include inadequate intraoperative head fixation using skeletal traction, uniplanar fluoroscopy-guided screw insertion, screw insertion using the posterior midline approach, and the use of 3.5 mm or thinner full-threaded screws.Graphical abstract These slides can be retrieved under Electronic Supplementary Material.

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Atlantoaxial instability treated with transarticular screw fixation

Cited by 6 publications

References 15 publications

Outcome Comparison of Atlantoaxial Fusion With Transarticular Screws and Screw-Rod Constructs

Outcome Comparison of Atlantoaxial Fusion With Transarticular Screws and Screw-Rod Constructs

Novel posterior artificial atlanto-odontoid joint for atlantoaxial instability: a biomechanical study

Potential intraoperative factors of screw-related complications following posterior transarticular C1–C2 fixation: a systematic review and meta-analysis

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