Biomechanical Comparison of Five Different Atlantoaxial Posterior Fixation Techniques

Henriques, Thomas; Cunningham, Bryan W.; Olerud, Claes; Shimamoto, Norimichi; Lee, Guy A.; Larsson, Sune; Mcafee, Paul A.

doi:10.1097/00007632-200011150-00007

Cited by 137 publications

(72 citation statements)

References 24 publications

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“…(2) This method obviates the procedure of removing posterior failed instrument first, while direct anterior release followed by posterior reduction and instrumentation is indicated. Several instrumentations have been described in the literature [14]. Anterior instruments placed on the pharyngeal wall predispose the risk of local infection; as a result, anterior screw loosening has been reported [11].…”

Section: Discussionmentioning

confidence: 99%

Revision surgery of irreducible atlantoaxial dislocation: a retrospective study of 16 cases

Tan

Jiang

et al. 2011

Eur Spine J

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There is lack data concerning anterior cervical spine revision surgeries; even more data are missing concerning posterior cervical revision surgeries, to determine the feasibility, safety, and clinical efficacy of revision surgery for irreducible atlantoaxial dislocation (RS-IAAD). Patients with IAAD-FS underwent one-stage transoral release and posterior reduction. Their medical history was documented in detail. The JOA score system was used to evaluate each patient's neurological status pre and postoperatively, and serial MRI and radiographs were used to determine the status of the reduction and the autografts. 16 patients (average age, 36 years old) underwent successful surgery. There was no intraoperative or postoperative neurological deficit except in two cases that suffered transient neurological deficit that alleviated after conservative treatment. Solid bony union was seen at the end of 3 months after surgery in all patients. The mean follow-up period was 28.8 months (range 18-66 months). No pseudarthrosis was noted. Anterior transoral release and posterior instrumented fusion remain significant surgeries with the potential for serious complications, but in the current series there were no major complications.

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Section: Discussionmentioning

confidence: 99%

Revision surgery of irreducible atlantoaxial dislocation: a retrospective study of 16 cases

Tan

Jiang

et al. 2011

Eur Spine J

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“…3). Bilateral transarticular screws lay a solid foundation for the internal fixation [17][18][19][20][21][22] and the hook system serves as a measure to fix the bone graft through pressing. An additional hook system on the intact side, instead of wiring, was adopted which had advantages [23][24][25] of (1) more stability as a supplement to bilateral transarticular screws in restricting the flexion-extension, (2) more safety without passing wires though the arch, and (3) higher efficiency in securing the structural bone graft with a longer torque pressing the posterior arch as compared with C1 lateral mass screw.…”

Section: Discussionmentioning

confidence: 99%

Post atlantoaxial fusion for unilateral cleft of atlas posterior arch associated with os odontoideum: case report and technique note

Yang

Yan

et al. 2011

Eur Spine J

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A case of a 34-year-old female with unilateral cleft of atlas posterior arch associated with os odontoideum is reported. The patient had experienced neck pain for 6 months. Five days earlier to admission the pain aggravated as a result of mild head trauma from behind. Imaging examinations revealed C1-2 subluxation as well as the deformity. After 3 days of skull traction, a sound C1-2 reduction was achieved. Post atlantoaxial fusion using bilateral transarticular screws combined with C1 laminar hook on the intact side and autogenous bone graft was performed. On the sixth month of postoperative follow-up, CT revealed solid fusion was achieved. No related complications were detected within 3 years of follow-up. The clinical manifestations and imaging findings were presented. The incidence and etiopathogenesis of hypoplastic posterior arch of the atlas were concisely introduced. Techniques of post atlantoaxial fusion under circumstances of unilateral C1 posterior elements defects were discussed. The authors believe bilateral transarticular screws combined with C1 laminar hook on the intact side and autogenous bone graft can be applicable to atlantoaxial fusion on the premise of preoperative C1-2 reduction and C1 posterior arch remaining [1/2 of its full length.

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“…These have evolved from posterior wiring techniques of Brooks, Gallie and Sonntag to screw fixation techniques. The Magerl transarticular technique provides significant fixation advantages over wiring techniques and up to a 100% fusion rate [5,[7][8][9]11]. However, anatomical reduction of C1 on C2 prior to screw insertion is required and there is potential for inadvertent vertebral artery injury [12].…”

Section: Discussionmentioning

confidence: 99%

C1 lateral mass screw-induced occipital neuralgia: a report of two cases

et al. 2009

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C1-2 polyaxial screw-rod fixation is a relatively new technique. While recognizing the potential for inadvertent vertebral artery injury, there have been few reports in the literature outlining all the possible complications. Aim of this study is to review all cases of C1 lateral mass screws insertion with emphasis on the evaluation of potential structures at risk during the procedure. We retrospectively reviewed all patients in our unit who had C1 lateral mass screw insertion over a 2-year period.

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Biomechanical Comparison of Five Different Atlantoaxial Posterior Fixation Techniques

Abstract: The current findings substantiate the use of three-point fixation as the treatment of choice for C1-C2 instability. [l: atlantoaxial fixation, biomechanics, cervical spine, instability, spinal instrumentation, transarticular screws]

Cited by 137 publications

References 24 publications

Revision surgery of irreducible atlantoaxial dislocation: a retrospective study of 16 cases

Revision surgery of irreducible atlantoaxial dislocation: a retrospective study of 16 cases

Post atlantoaxial fusion for unilateral cleft of atlas posterior arch associated with os odontoideum: case report and technique note

C1 lateral mass screw-induced occipital neuralgia: a report of two cases

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