Clinical outcomes of posterior c1 and c2 screw-rod fixation for atlantoaxial instability

Işik, Hasan Serdar; Sandal, Evren; Çağlı, Sedat

doi:10.5137/1019-5149.jtn.20525-17.1

Cited by 8 publications

(8 citation statements)

References 38 publications

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“… 96.5 (28/29) NR NR NR 5 Sai Kiran et al [ 77 ] 2018 India 24 49 NR NR 94 30 (16.3) 61:33 Retrospective Upendra et al classification 100 (24/24) 100 (49/49) NR NR 9 Işik et al . [ 78 ] 2018 Turkey 24 8 NR NR 16 of 28 of patients 44.7 (21–73 ) 11:17 Retrospective Post-op CT, without classification 100 (24/24) 100 (8/8) NR NR 6 Park et al [ 79 ] 2019 South Korea NR 76 NR NR 58 62.4 (14.5) 20:38 Retrospective Modified Upendra NR 97.4 NR NR 8 Zhang et al [ 80 ] 2019 China 68 NR NR NR 36 6.9 (3.2) 21:15 Retrospective Smith classification 98.5 (67/68) NR NR NR 8 Wu et al [ 9 ] 2019 China NR NR 54 NR 27 38.5 (22–62) 17:10 Prospective …”

Section: Resultsmentioning

confidence: 99%

Accuracy and safety of C2 pedicle or pars screw placement: a systematic review and meta-analysis

et al. 2020

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Study design: Systematic review and meta-analysis. Aim: The purpose of this study was to compare the safety and accuracy of the C2 pedicle versus C2 pars screws placement and free-hand technique versus navigation for upper cervical fusion patients. Methods: Databases searched included PubMed, Scopus, Web of Science, and Cochrane Library to identify all papers published up to April 2020 that have evaluated C2 pedicle/pars screws placement accuracy. Two authors individually screened the literature according to the inclusion and exclusion criteria. The accuracy rates associated with C2 pedicle/pars were extracted. The pooled accuracy rate estimated was performed by the CMA software. A funnel plot based on accuracy rate estimate was used to evaluate publication bias. Results: From 1123 potentially relevant studies, 142 full-text publications were screened. We analyzed data from 79 studies involving 4431 patients with 6026 C2 pedicle or pars screw placement. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of studies included in this review. Overall, funnel plot and Begg's test did not indicate obvious publication bias. The pooled analysis reveals that the accuracy rates were 93.8% for C2 pedicle screw free-hand, 93.7% for pars screw free-hand, 92.2% for navigated C2 pedicle screw, and 86.2% for navigated C2 pars screw (all, P value < 0.001). No statistically significant differences were observed between the accuracy of placement C2 pedicle versus C2 pars screws with the free-hand technique and the free-hand C2 pedicle group versus the navigated C2 pedicle group (all, P value > 0.05). Conclusion: Overall, there was no difference in the safety and accuracy between the free-hand and navigated techniques. Further well-conducted studies with detailed stratification are needed to complement our findings.

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Section: Resultsmentioning

confidence: 99%

Accuracy and safety of C2 pedicle or pars screw placement: a systematic review and meta-analysis

et al. 2020

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“…We intend to make a brief discussion of the situation, for which we have prepared a summary table with the largest and most important manuscripts, which may allow us to draw conclusions. According to the scientific literature, C1-C2 instability (atlantoaxial subluxation) is a problem with multiple etiologies [40,[70][71][72][73][74], which, due to the mild neurological symptoms [75] in the initial phase, can be difficult to diagnose by the complexity of the interpretation of simple imaging tests. This fact generates delays in diagnosis and will compromise the capacity for reduction and recurrence of the deformity [40].…”

Section: Discussionmentioning

confidence: 99%

“…According to the scientific literature, C1-C2 instability (atlantoaxial subluxation) is a problem with multiple etiologies [ 40 , 70 , 71 , 72 , 73 , 74 ], which, due to the mild neurological symptoms [ 75 ] in the initial phase, can be difficult to diagnose by the complexity of the interpretation of simple imaging tests. This fact generates delays in diagnosis and will compromise the capacity for reduction and recurrence of the deformity [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

C1-C2 Rotatory Subluxation in Adults “A Narrative Review”

González

Aragón

Sanjuan³

et al. 2022

Diagnostics

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The atlantoaxial joint C2 (axis) with the anterior arch of C1 (atlas) allows 50% of cervical lateral rotation. It is responsible for precise and important movements that allow us to perform precise actions, both in normal and working life. Due to low incidence in adults, this condition often goes undiagnosed, or the diagnosis is delayed and the outcome is worse. An early diagnosis and treatment are essential to ensure satisfactory neurological and functional outcomes. The aim of this review is to analyze C1-C2 rotatory subluxation in adults, given its rarity. The time between injury and reduction is key, as it is directly related to prognosis and the severity of the treatment options. Due to low incidence in adults, this condition often goes undiagnosed, or the diagnosis is delayed as a lot of cases are not related to a clear trauma, with a poor prognosis just because of the late diagnosis and the outcome is worse. The correct approach and treatment of atlantoaxial dislocation requires a careful study of the radiological findings to decide the direction and plane of the dislocation, and the search for associated skeletal anomalies.

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“…(2018) showed in 28 patients, there were no poorly placed screws, and they observed significant postoperative clinical improvement (e.g., JOA and VAS scores). [ 6 ] Zheng et al ., in 2016, also reported significant recovery and a 97.7% fusion rate, a finding (97% fusion rate in 60 patients using Goel/Harms technique) also echoed by Rajinda et al . [ 7 , 8 ] Here, we also found acceptable long-term results utilizing the Goel/Harms technique without any evidence of radiological or clinical deterioration an average of 48.9 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Clinicoradiological outcomes of Goel and Harms fixation for atlantoaxial instability: An institutional experience

Sharma¹,

Kalidindi²,

Sangondimath³

et al. 2020

Surgical Neurology International

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Background: Few studies have reported on the long-term outcomes of Goel and Harms C1-C2 fusions in the Asian population. Methods: This was a retrospective analysis of 53 patients undergoing Goel and Harms fixation (2010 –2018). Clinical outcomes were assessed utilizing the neck disability index (NDI), Japanese Orthopedic Association (JOA) score, and visual analog scale (VAS). Outcomes were then correlated with fusion rates (using dynamic X-rays), atlanto-dens interval (ADI), and space available for cord (SAC) data. Results: The study’s 53 patients averaged 49.98 years of age and included 42 males and 11 females. The mean preoperative versus postoperative scores on multiple outcome measures showed NDI 31.62 ± 11.05 versus decreased to 8.68 ± 3.76 post, mean JOA score (e.g., in 41 patients with myelopathy) improved from 13.20 ± 3.96 to 15.2 ± 2.17, and the mean VAS decreased from 4.85 ± 1.03 to 1.02 ± 0.87 and showed restoration of the ADI (1.96 ± 0.35 mm) and SAC (20.42 ± 0.35 mm). A 98.13% rate of C1-C2 fusion was achieved at 12 postoperative months. Conclusion: Goel and Harms technique for C1-C2 fusion resulted in both good clinical and radiological outcomes.

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Clinical outcomes of posterior c1 and c2 screw-rod fixation for atlantoaxial instability

Cited by 8 publications

References 38 publications

Accuracy and safety of C2 pedicle or pars screw placement: a systematic review and meta-analysis

Accuracy and safety of C2 pedicle or pars screw placement: a systematic review and meta-analysis

C1-C2 Rotatory Subluxation in Adults “A Narrative Review”

Clinicoradiological outcomes of Goel and Harms fixation for atlantoaxial instability: An institutional experience

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