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Related Experiment Videos

C1-C2 transarticular screw fixation: technical aspects.

R W Haid1

  • 1Department of Neurosurgery, Emory Clinic, Emory University School of Medicine, Atlanta, Georgia 30322, USA. regis_haid@emory.org

Neurosurgery
|July 7, 2001
PubMed
Summary
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Clinical neurosurgery·2001

Posterior atlantoaxial fusion using C1-C2 transarticular screw fixation achieves high fusion rates (96%) with minimal complications. Meticulous surgical technique and preoperative imaging are key to successful outcomes in treating atlantoaxial instability.

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Fusion Techniques

Background:

  • Atlantoaxial instability can result from trauma, inflammatory conditions like rheumatoid arthritis, or congenital abnormalities such as os odontoideum.
  • Posterior atlantoaxial fusion aims to stabilize the C1-C2 articulation, restoring biomechanical integrity.

Purpose of the Study:

  • To review the indications, complications, and operative technique of posterior atlantoaxial fusion with transarticular screw fixation.
  • To emphasize the author's experience and outcomes with this surgical approach.

Main Methods:

  • Utilized C1-C2 transfacetal screws (Magerl technique) for stabilization.
  • Employed supplemental interspinous fusion with iliac crest graft and titanium cable (Sonntag technique) for posterior tension band restoration.

Related Experiment Videos

  • Preoperative imaging included plain radiographs, MRI, and axial CT; patients were postoperatively immobilized in a rigid cervical orthosis.

    • Main Results:

    • Achieved a fusion rate of 96% (72 out of 75 patients).
    • Reported no instances of vertebral artery injury, screw malplacement, instrumentation failure, dural laceration, spinal cord injury, or hypoglossal nerve injury.
    • Safety and efficacy were enhanced by specific patient positioning, fluoroscopic guidance, and preoperative imaging.

    Conclusions:

    • C1-C2 transarticular screw fixation combined with a posterior tension band construct is an effective method for achieving atlantoaxial fusion.
    • Excellent fusion rates and a low complication profile are associated with this technique.
    • Thorough preoperative imaging and precise surgical execution are critical for optimal patient outcomes.