Original Article

C1-C2 Transarticular Screw Fixation for Atlantoaxial Instability

Authors: K N. Fountas, MD, PHD, E Z. Kapsalaki, MD, PHD, I Karampelas, MD, V G. Dimopoulos, MD, C H. Feltes, MD, M A. Kassam, MD, A N. Boev, MS, III, K W. Johnston, MD, FACS, H F. Smisson, MD, FACS, E C. Troup, MD, J S. Robinson, Jr, MD, FACS

Abstract

Objectives: The atlantoaxial segment of the cervical spine is commonly destabilized in a variety of disorders. Transarticular screw fixation of the C1-C2 joint has been proposed as a biomechanically superior therapeutic modality. The authors present their experience with this technique.


Methods: A retrospective analysis of 23 patients treated with this technique was performed. The mean follow-up period was 39.5 ± 0.1 months.


Results: Mean duration of hospitalization was 3.4 ± 0.1 days (range, 2 to 11 days). No intraoperative or early postoperative complications were detected. Four patients (17.4%) had postoperative complications unrelated to the primary procedure. The position of the screw was judged as satisfactory in 21 patients (91.3%). Two patients (8.7%) with suboptimal positioning of the screws were neurologically intact but needed no reoperation. Solid osseous fusion was detected in 19 patients (82.6%).


Conclusions: Transarticular C1-C2 screw fixation appears to be a safe and surgically reliable technique. Criteria for its application and refinements in its technical considerations continue to advance its clinically versatile therapeutic potential.


Key Points


* Transarticular C1-C2 screw fixation is favored as a biomechanically superior stabilization procedure.


* A retrospective series of 23 patients treated with this modality is presented.


* Postoperative complications and long-term results are analyzed.


* Indications for this technique are also discussed by the authors.

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