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

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

doi:10.1097/bsd.0b013e318277da19

Cited by 94 publications

(62 citation statements)

References 66 publications

(83 reference statements)

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“…9) for C1-C2 fixation. This instrument provides excellent immobilization with fewer complications compared with other posterior atlantoaxial fixation instruments [2,[30][31][32][33][34]. Since then, this technique has become increasingly popular [35].…”

Section: Screw-rod Systemmentioning

confidence: 98%

Posterior atlantoaxial fixation: a review of all techniques

et al. 2015

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Section: Screw-rod Systemmentioning

confidence: 98%

Posterior atlantoaxial fixation: a review of all techniques

et al. 2015

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“…[345] Comparative biomechanical and long-term studies of the surgical fixation techniques performed in this region are present in the literature. [23456789101112] Lately, translaminar fixation technique is becoming more popular. [13] The selection of the fixation technique for C1-C2 posterior arthrodesis surgery depends on a lot of factors such as the anatomy of the upper cervical vertebrae (C1 and C2), anomalies, deformities, VA variations, nonreductable fractures and most importantly the experience of the surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…[6] Despite that, it is stated in the latest publications that the complication rates with Goel technique might just be as high as in Magerl technique. [11] Finn et al performed Magerl technique on 269 cases, indicated 15% complication rate of which one case was fatal, and reported that this technique has many disadvantages. [16]…”

Section: Discussionmentioning

confidence: 99%

C1-2 posterior arthrodesis technique with a left segmental and right transarticular fixation. A hybrid novel (Kotil) technique

Kotıl

Muslumanoglu

2014

J Craniovert Jun Spine

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Introduction:The most commonly used techniques for C1-C2 posterior arthrodesis are Goel and Magerl fixation techniques. Due to the anatomical variations of the region, the prior determination of the surgical technique might be hard. Right side Magerl, left side Goel's C1-C2 posterior arthrodesis case is presented as a new surgical combination technique used due to anatomical difficulties.Materials and Methods:Posterior C1-C2 arthrodesis operation was indicated for a 56-year-old female patient for the treatment of atlanto-axial subluxation caused by os odontoideum. First it was fixed from the nondominant arterial side (right vertebral artery) with Magerl (transarticular) technique. The left side was not suitable for the anatomical transarticular fixation, and the contralateral Goel fixation technique (segmental) was performed. Eventually, right side transarticular left side segmental fixation techniques were combined in one patient for the first time and C1-C2 fusion combination technique was presented.Results:Both Goel and Magerl techniques of C1-C2 posterior fusion techniques were successfully used simultaneously. The operation was initiated with Magerl technique with one screw on the nondominant side. The contralateral side was not suitable for Magerl technique therefore we changed to Goel's technique. Although, fluoroscopy was used 3 times as much during the introduction of the Drill with Magerl technique, twice as much operative time was spent during hemostasis and bleeding, preparation of the C1 entry point, and the reconstruction of polyaxial screws for Goel technique. No neurovascular complications were occurred during both procedures.Discussion:Combination of two C1-C2 posterior fusion techniques, Goel and Magerl, in suitable cases caused by anatomical or other reasons appears to be an alternative surgical procedure that protects the patient from complications. For a collection of better data, other studies that include large numbers of patients with high evidential value should be conducted.

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“…24 Also, comparison with Magerl's technique has shown similar biomechanical characteristics for both stabilization methods. 25 Posterior element integrity is not a necessity for this technique as it can be applied in fractures of the laminae. 26 In addition, the provided biomechanical construction sustained by polyaxial screws and rods allows for corrective intraoperative surgical manipulations to the occipitocervical junction.…”

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

Cited by 94 publications

References 66 publications

Posterior atlantoaxial fixation: a review of all techniques

Posterior atlantoaxial fixation: a review of all techniques

C1-2 posterior arthrodesis technique with a left segmental and right transarticular fixation. A hybrid novel (Kotil) technique

C1-C2 Posterior Cervical Fixation by a Harms Technique Modification

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