C2 Pedicle Screw and Plate Combined With C1 Titanium Cable Fixation for the Treatment of Alantoaxial Instability not Suitable for Placement of C1 Screw

Xiao, Zeng; Zhan, Xin Li; Gong, De Feng; Chen, Qian Fen; Luo, Gao Bin; Jiang, Hua

doi:10.1097/bsd.0b013e31815c5fba

Cited by 12 publications

(6 citation statements)

References 14 publications

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“…In an extensive survey, the risk of VA injury was 4.1% per patient or 2.2% per screw inserted with a consecutive risk of neurological deficit of 0.2% per patient or 0.1% per screw 22 The mortality rate was 0.1%. 22 Recently, Xiao et al 23 reported a method that uses C2 pedicle screws and a plate combined with C1 titanium cable fixation to treat atlantoaxial instability when the placement of C1 screws is not preferable or possible. However, the surgical procedures required are much more complicated than those of other fixation techniques, such as C1 hooks.…”

Section: Discussionmentioning

confidence: 98%

Outcome of Bilateral C1 Laminar Hooks Combined With C2 Pedicle Screw Fixation for the Treatment of C1–C2 Instability

Lao

Zhong²,

Li³

et al. 2017

Clinical Spine Surgery: A Spine Publication

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Section: Discussionmentioning

confidence: 98%

Outcome of Bilateral C1 Laminar Hooks Combined With C2 Pedicle Screw Fixation for the Treatment of C1–C2 Instability

Lao

Zhong²,

Li³

et al. 2017

Clinical Spine Surgery: A Spine Publication

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“…An important advantage of this method is that it does not require external immobilization (Guo et al, 2009) Although the method is safe, it has been reported that its applicability over time is technically difficult and causes various complication (Richter et al, 2002).The most important disadvantage in the posterior approaches is the loss of axial rotation but they have high fusion rate (Richter et al, 2002;Guo et al, 2009). Therefore, surgical techniques applied for this region have been developed from past to present and many techniques have been reported by some authors (Goel and Laheri, 1994;Goel et al, 2002;Xiao et al, 2008;Guo et al, 2009;Guo et al, 2014). Traditionally, posterior wire stabilization and structural bone grafting doesn't provide adequate immobilization of atlantoaxial complex.…”

Section: Discussionmentioning

confidence: 99%

The application of C2 transpedicular screw, C1 laminar hook fixation and bone graft in the atlantoaxial instability

Oral¹

2021

J Exp Clin Med

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Traumatic atlantoaxial instability usually results from a motor vehicle accident, falls and motorcycle accidents. Atlantoaxial instability can lead to spinal cord compression and neck pain, but, spasticity and radicular symptoms as well. The purpose of surgery is to remove the compression and stabilize the joint permanently. To date, several surgical techniques have been described to remedy C1-C2 instability. In this study, the clinical and radiological outcomes of patients who operated with the C1 (Atlas bone) laminar hooks fixation and bilateral C2 (Axis bone) trans-pedicular screw technique were shown. Also, the advantages and disadvantages of this technique are discussed. From March 2010 to December 2017, 12 patients who have atlantoaxial instability were surgically treated by modified fixation technique which consists C1 laminar hooks fixation and bilateral C2 transpedicular screw. Twelve patients were operated with this procedure from March 2010 to December 2017. All the patients were checked with flexion-extension x-rays at the end of the twelfth week. The posterior bony fusion formation was observed on imaging in all patients. C2 bilateral pedicle screw combined with C1 laminar hook system is a good method for atlantoaxial instability in the conditions which is not convenient for insertion of C1 lateral mass and C2 trans-articular screw. However, this method may not be available in some cases such as traumatic, infection, neoplastic or degenerative pathologies in which the posterior arch of the atlas is damaged.

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“…It should be noted, however, that a method of titanium cable-screw-plate fixation of the C1–C2 and a case series of eight patients treated successfully using the method has been reported. [ 31 ] Therefore, screws were also inserted into the C3 facets to distribute the load required to stabilize the support rod. The results of our clinical application of this technique demonstrated that when facet screws were inserted into both C2 and C3, they could satisfactorily tolerate the force required for reduction and rotation.…”

Section: Discussionmentioning

confidence: 99%

Treatment of type II odontoid fracture with a novel technique

Zhu

Wang²,

Song³

et al. 2017

Medicine

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Surgical methods for type II odontoid fracture can be classified into 2 main groups: anterior or posterior approach. A more effective way to achieve bone fusion with the lowest possible surgical risk is needed. Therefore, the aim of our study was to describe and evaluate a novel technique, cable-dragged reduction/cantilever beam internal fixation for the treatment of type II odontoid fracture.This was a retrospective study enrolled 34 patients underwent posterior cable-dragged reduction/cantilever-beam internal fixation surgery. Medical records, rates of reduction, the location of the instrumentation and fracture healing during follow-up were analyzed. Once fracture healing was obtained, instrumentation was removed. Neck pain (scored using a visual analog scale [VAS]), neck stiffness, patient satisfaction, and neck disability index (NDI) were recorded before and after removing the instrumentation during follow-up.The mean duration of follow up was 22.8 ± 5.3 months. There was no iatrogenic damage to nerves or blood vessels. Radiographic evaluation showed complete reduction in the 20 patients with fracture displacement and satisfactory fracture healing in all 34 cases. Titanium cable breakage was observed in 4 patients after fracture healing. After removal of instrumentation, significant improvements were seen in neck-pain VAS score, neck stiffness, patient satisfaction, and NDI (all P < .01).Posterior cable-dragged reduction/cantilever-beam internal fixation was an optimal salvage maneuver to conventional surgical methods such as anterior screw fixation and C1–C2 screw-rod system. The operative difficulty and incidence of nerve and vascular injury were reduced. Its major disadvantage is the exposure and screw-setting at C3, which is left intact in traditional surgery, and it is suitable only for patients with intact C1 posterior arches.

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C2 Pedicle Screw and Plate Combined With C1 Titanium Cable Fixation for the Treatment of Alantoaxial Instability not Suitable for Placement of C1 Screw

Abstract: C2 pedicle screw and plate combined with C1 titanium cable could be used to treat atlantoaxial instability in the cases not suitable for placement of C1 screw.

Cited by 12 publications

References 14 publications

Outcome of Bilateral C1 Laminar Hooks Combined With C2 Pedicle Screw Fixation for the Treatment of C1–C2 Instability

Outcome of Bilateral C1 Laminar Hooks Combined With C2 Pedicle Screw Fixation for the Treatment of C1–C2 Instability

The application of C2 transpedicular screw, C1 laminar hook fixation and bone graft in the atlantoaxial instability

Treatment of type II odontoid fracture with a novel technique

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