C2 Translaminar Screw Fixation (Wright`s Technique) Applicability in Atlantoaxial Instability

Abstract

A instabilidade atlantoaxial possui múltiplas causas e muitas vezes requer tratamento cirúrgico. Várias técnicas estão disponíveis para realização da fixação atlantoaxial, todas elas com diferentes vantagens e desvantagens. Em 2004, Wrigth descreveu a técnica de fixação translaminar de C2, que oferece uma fixação rígida, porém sem a dificuldade técnica da colocação de parafusos na pars de C2 e com eliminação do risco de lesão da artéria vertebral. O objetivo deste estudo é revisar a técnica de fixação translaminar de C2, enfatizando detalhes técnicos, risco e benefícios em comparação com as outras técnicas de fixação atlantoaxial. Palavras-chave: Coluna Vertebral; Articulação Atlantoaxial;Áxis; Fusão Vertebral: instrumentação. ABSTRACTAtlantoaxial instability often requires surgical treatment. Several techniques are available to perform antlantoaxial stabilization, and all of these have their different advantages and disadvantages. In 2004, Wright described the C2 translaminar screw fixation, which offers rigid fixation but without the technical demands of C2 pars placement and eliminates the risk of vertebral artery injury. The aim of this study is to review the C2 translaminar screw fixation technique, emphasizing operative details, risks and benefits comparing with the others atlantoaxial fixation techniques. J Bras Neurocirurg 23 (2): 152-156, 2012 Aurich LA, Milano JB, Junior EBS, Ramina R -C2 Translaminar Screw Fixation (Wright`s Technique) Applicability in Atlantoaxial Instability

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“…The technique described by Wright in 2004 is technically simpler and with a lower risk of vascular or nerve injury compared to the previous ones, presenting overlapping biomechanical resistance. 6,10,11 In conclusion, adult Grisel's Syndrome is an extremely rare entity whose diagnosis may be delayed by the time lapse between the infectious event and the cervical symptoms. In this age group, surgical treatment is often required, but there is a lack of large sample studies to make strong recommendations regarding treatment in the adult subset of patients.…”