Occipitoaxial spinal interarticular stabilization with vertebral artery preservation for atlantal lateral mass failure

Abstract

<jats:p>The treatment of craniocervical instability caused by diverse conditions remains challenging. Different techniques have been described to stabilize the craniocervical junction. The authors present 2 cases in which tumoral destruction of the C-1 lateral mass caused craniocervical instability. A one-stage occipitoaxial spinal interarticular stabilization (OASIS) technique with titanium cages and posterior occipitocervical instrumentation was used to reconstruct the C-1 lateral mass and stabilize the craniocervical junction. The ipsilateral vertebral artery was preserved.</jats:p> <jats:p>The OASIS technique offers single-stage tumor resection, C-1 lateral mass reconstruction, and stabilization with a loadsharing construct. It could be an option in the treatment of select cases of C-1 lateral mass failure.</jats:p>

Bilateral C-1 lateral mass reconstruction following radical resection of a giant osteoblastoma of the atlas: case report

“…14,17 CVJ reconstruction after partial or complete excision of the C-1 lateral masses has been described only in case reports (Table 1). 4,8,37,38 Small case series in which longer constructs were used in the subaxial cervical spine have also been published. 9,13 What is unusual in our case is the extensive resection of both lateral masses of C-1, with loss of normal-load bearing capacity of the head.…”

“…The OASIS technique following tumor resection has been previously described by our group for unilateral lesions. 4 gation was done at an outside hospital with plain cervical radiographs, which were interpreted as normal. Cervical MRI, performed because of the patient's persistent neck pain, showed a mass centered on the posterior arch of C-1.…”

Biomechanical Assessment of Stabilization of Simulated Type II Odontoid Fracture with Case Study

“…The authors of the present study believe that scraping and preparing the articular joint promotes bone growth, as has been seen in discectomy and endplate preparation techniques used in interbody fusion, but that construct rigidity, in terms of motion, remains stable until fusion occurs. Concerns regarding vertebral artery complications can be addressed by care and repositioning, as was discussed in previous clinical cases reported by Bobinski et al [ 30 ], in which spacers as large as 10 mm were used in the C1–C2 articular joint. Finally, this technique allows use of a posterior approach only, thereby reducing the number of surgical incisions.…”