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Related Experiment Videos

Anterior instrumentation for traumatic C1-C2 instability.

Rudy Reindl1, Milan Sen, Max Aebi

  • 1McGill University Health Center, Montreal, Quebec, Canada.

Spine
|September 16, 2003
PubMed
Summary

Anterior internal fixation effectively stabilizes traumatic C1-C2 instability using odontoid and C1 lateral mass screws. This minimally invasive approach offers advantages over posterior methods for C1-C2 joint fixation.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spine Surgery

Background:

  • Posterior approaches for C1-C2 instrumentation involve extensive dissection and prone positioning.
  • Certain patient conditions limit the feasibility of posterior surgical approaches.

Observation:

  • This technical note describes anterior transarticular screw fixation for C1-C2 instability.
  • A type II dens fracture with C1 ring disruption was treated with an odontoid screw and anterior C1-C2 screws.
  • The procedure utilized fluoroscopy, a radiolucent table, and a specialized retraction system.

Findings:

  • Successful stabilization was achieved at 4-month follow-up without hardware failure.
  • The patient maintained stable neurologic status with a minor motor deficit.

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  • Restricted C-spine rotation was noted, but neck pain was absent.

    • Implications:

    • Anterior C1-C2 screw fixation via the Smith-Robinson approach is an effective stabilization method.
    • Advantages include supine positioning and reduced soft tissue dissection compared to posterior techniques.
    • Careful anatomical knowledge and surgical technique are crucial for avoiding complications.