Title : Experience with posterior atlantoaxial segmental fixation
Abstract:
Objective: The atlantoaxial instability is a serious problem that can be solved in most recent studies posterior reduction and fixation surgery. There are many described techniques for C1-C2 fixation. In this work C1-C2 segmental screws was used aiming to study it.s efficency and safety.
Material and method: Between jan 2011 and September 2016, 22 patients underwent posterior fixation using C1 lateral mass and C2 screw (pars in 4 cases and pedicle in 7 cases, translaminar screw in 11 case))with rod fixation. It should be mentioned that before screw placement ,reduction was achieved by both traction and opening of C1-C2 joint and insertion of bone either from iliac crest or spinous process of cervical vertebrae that help in distraction of the joint and fusion Transoral reduction and decompression was done first in two cases.occiptal condyle fixation ( C Zero)was adone in addition in a single case.
Results: Reduction +/- decompression and C1 lateral mass and C2 pars , pedicle or translaminar screw were used to achieve C1-C2 stabilization in all patients. Optimum insertion was achieved in all screws.There was single case with dural tear and another case with wound infection but there were no permanent complications. Myelopathic manifestation show improvement to varying degree in all cases. Rigid fixation and sabilization was confirmed on postoperative radiographs and maintained on follow-up radiograph.
Conclusion: Posterior reduction and fixation using C1 lateral mass and C2 screws is an effective and safe method of stabilizing the atlantoaxial spine.
