Atlantoaxial stabilization with the use of C1-3 lateral mass screw fixation: Technical note

Eric Horn, Jonathan S. Hott, Randall W. Porter, Nicholas Theodore, Stephen M. Papadopoulos, Volker K H Sonntag

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Atlantoaxial stabilization has evolved from simple posterior wiring to transarticular screw fixation. In some patients, however, the course of the vertebral artery (VA) through the axis varies, and therefore transarticular screw placement is not always feasible. For these patients, the authors have developed a novel method of atlantoaxial stabilization that does not require axial screws. In this paper, they describe the use of this technique in the first 10 cases. Ten consecutive patients underwent the combined C1-3 lateral mass-sublaminar axis cable fixation technique. The mean age of the patients was 62.6 years (range 23-84 years). There were six men and four women. Eight patients were treated after traumatic atlantoaxial instability developed (four had remote trauma and previous nonunion), whereas in the other two atlantoaxial instability was caused by arthritic degeneration. All had VA anatomy unsuitable to traditional transarticular screw fixation. There were no intraoperative complications in any of the patients. Postoperative computed tomography studies demonstrated excellent screw positioning in each patient. Nine patients were treated postoperatively with the aid of a rigid cervical orthosis. The remaining patient was treated using a halo fixation device. One patient died of respiratory failure 2 months after surgery. Follow-up data (mean follow-up duration 13.1 months) were available for seven of the remaining nine patients and demonstrated a stable construct with fusion in each patient. The authors present an effective alternative method in which C1-3 lateral mass screw fixation is used to treat patients with unfavorable anatomy for atlantoaxial transarticular screw fixation. In this series of 10 patients, the method was a safe and effective way to provide stabilization in these anatomically difficult patients.

Original languageEnglish (US)
Pages (from-to)172-177
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume5
Issue number2
DOIs
StatePublished - Aug 2006
Externally publishedYes

Fingerprint

Vertebral Artery
Anatomy
Orthotic Devices
Intraoperative Complications
Respiratory Insufficiency
Arthritis
Tomography
Equipment and Supplies
Wounds and Injuries

Keywords

  • Cervical spine
  • Fixation
  • Fracture
  • Fusion
  • Vertebral artery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Horn, E., Hott, J. S., Porter, R. W., Theodore, N., Papadopoulos, S. M., & Sonntag, V. K. H. (2006). Atlantoaxial stabilization with the use of C1-3 lateral mass screw fixation: Technical note. Journal of Neurosurgery: Spine, 5(2), 172-177. https://doi.org/10.3171/spi.2006.5.2.172

Atlantoaxial stabilization with the use of C1-3 lateral mass screw fixation : Technical note. / Horn, Eric; Hott, Jonathan S.; Porter, Randall W.; Theodore, Nicholas; Papadopoulos, Stephen M.; Sonntag, Volker K H.

In: Journal of Neurosurgery: Spine, Vol. 5, No. 2, 08.2006, p. 172-177.

Research output: Contribution to journalArticle

Horn, E, Hott, JS, Porter, RW, Theodore, N, Papadopoulos, SM & Sonntag, VKH 2006, 'Atlantoaxial stabilization with the use of C1-3 lateral mass screw fixation: Technical note', Journal of Neurosurgery: Spine, vol. 5, no. 2, pp. 172-177. https://doi.org/10.3171/spi.2006.5.2.172
Horn, Eric ; Hott, Jonathan S. ; Porter, Randall W. ; Theodore, Nicholas ; Papadopoulos, Stephen M. ; Sonntag, Volker K H. / Atlantoaxial stabilization with the use of C1-3 lateral mass screw fixation : Technical note. In: Journal of Neurosurgery: Spine. 2006 ; Vol. 5, No. 2. pp. 172-177.
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