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Atlantoaxial stabilization using multiaxial C-1 posterior arch screws
Michael B Donnellan1, Ioannis G Sergides, William R Sears
1Department of Neurosurgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Journal of Neurosurgery. Spine
|November 28, 2008
Summary
A new C-1 posterior arch screw technique offers solid atlantoaxial fixation, simplifying procedures for patients with complex anatomy and potentially reducing complications.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Fusion Techniques
Background:
- Traditional atlantoaxial fixation methods can be challenging in patients with anatomical variations.
- Existing techniques like transarticular screws or C-1 lateral mass screws may not be suitable for all cases.
Observation:
- A novel technique utilizing bilateral multiaxial C-1 posterior arch screws connected by crosslinked rods to C-2 pars screws was developed.
- This method was applied in three patients with vertebral artery anomalies, C-1 lateral mass, or posterior arch abnormalities.
Findings:
- The C-1 posterior arch screw technique achieved solid fixation in all cases.
- Insertion of these screws was technically less demanding compared to transarticular or C-1 lateral mass screws.
Implications:
- This technique offers a potentially safer and more accessible fixation option for atlantoaxial instability, particularly in patients with challenging anatomy.
- It may reduce the risk of complications associated with vertebral artery or C-1 structural anomalies.
- The method could also be a viable alternative for patients with normal anatomy.
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