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[Posterior osteosynthesis in C1-C2 instability].

P Bartolozzi1, M Salvi, M Misasi

  • 1Cattedra di Traumatologia della Strada, Università degli Studi di Cagliari.

Archivio "Putti" Di Chirurgia Degli Organi Di Movimento
|January 1, 1990
PubMed
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Posterior stabilization effectively treats C1-C2 instability from rheumatoid arthritis (RA) or non-union in patients with mild symptoms. Severe neurological deficits, however, are a contraindication for this surgical approach.

Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Rheumatology

Background:

  • C1-C2 segment instability can result from rheumatoid arthritis (RA) or non-union.
  • This instability poses risks for neurological compromise.

Purpose of the Study:

  • To evaluate the efficacy of posterior stabilization with wire loops and bone grafts for C1-C2 instability.
  • To identify patient factors influencing treatment outcomes and contraindications.

Main Methods:

  • Retrospective review of 8 cases with C1-C2 instability.
  • Treatment involved posterior stabilization using wire loops and bone grafts.
  • Analysis of neurological status and radiographic parameters.

Main Results:

Related Experiment Videos

  • Good outcomes were observed in patients with mild neurological involvement and specific radiographic instability criteria (dens subluxation >1/3 A-P diameter of C1 or tilting >30 degrees).
  • One patient with non-union, severe neurological involvement (quadriparesis), and respiratory palsy died post-operatively.

    • Conclusions:

    • Posterior stabilization is a viable treatment for select C1-C2 instability cases.
    • Severe long-term neurological involvement, such as quadriparesis, is a contraindication for this procedure due to significant risks.