Minimally Invasive Posterior Transarticular Stand-Alone Screw Instrumentation of C1–C2 Using a Transmuscular Approach: Description of Technique, Results and Comparison with Posterior Midline Exposure

Lvov, Ivan; Грин, А. А.; Kordonskiy, Anton; Сытник, А. В.; Smirnov, Vladimir; Khushnazarov, Ulugbek; Krylov, Vladimir

doi:10.1016/j.wneu.2019.04.259

Cited by 10 publications

(10 citation statements)

References 9 publications

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“…For a patient population as mentioned above, IPTSFC1/C2 may represent a safe surgical treatment option with the smallest possible surgical trauma to enable rapid remobilization and dehospitalization. Our data agree with those found in the literature on this subject 12 – 14 . The advantage of percutaneous transarticular screw fixation over the classic transarticular screw fixation of C1 and C2 as an open approach is the significantly lower surgical invasiveness 10 .…”

Section: Discussionsupporting

confidence: 93%

“…The retrospectively collected data of the above-described cohort revealed that IPTSFC1/C2 is a safe surgical technique, as already described 11 , 14 . Performed by experienced surgeons it is associated with only rare implant malpositioning, few perioperative complications, and low revision rates.…”

Section: Discussionsupporting

confidence: 60%

“…Many authors have addressed minimally invasive techniques for spinal fracture repair in the past 6 – 9 . The technique described by Magerl et al has frequently been modified and techniques for performing the procedure in a minimally invasive manner have been developed 10 – 14 . In some of the minimally invasive procedures, in addition to percutaneous screw fixation, dorsal spondylodesis is established in a mini open procedure 10 , 12 , 14 .…”

Section: Introductionmentioning

confidence: 99%

“…The technique described by Magerl et al has frequently been modified and techniques for performing the procedure in a minimally invasive manner have been developed 10 – 14 . In some of the minimally invasive procedures, in addition to percutaneous screw fixation, dorsal spondylodesis is established in a mini open procedure 10 , 12 , 14 . However, some authors have demonstrated isolated percutaneous techniques without an additional spinal fusion 11 , 14 .…”

Section: Introductionmentioning

confidence: 99%

“…In some of the minimally invasive procedures, in addition to percutaneous screw fixation, dorsal spondylodesis is established in a mini open procedure 10 , 12 , 14 . However, some authors have demonstrated isolated percutaneous techniques without an additional spinal fusion 11 , 14 . We also performed isolated percutaneous transarticular screw fixation of C1 and C2 (IPTSFC1/C2) without establishing a spinal fusion by bone grafting in selected cases.…”

Section: Introductionmentioning

confidence: 99%

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The limitations of fully threaded screws in isolated percutaneous transarticular screw fixation of C1/C2

Koepke

Heuer

Stangenberg

et al. 2022

Sci Rep

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Demographic aging accompanied by increased falls inevitably leads to an increased incidence of atlantoaxial instabilities (AAI). Minimally invasive surgical procedures decrease the perioperative risk and regarding the treatment of AAI, percutaneous transarticular screw fixation of C1/C2 was more frequently considered in the past. This study aims to investigate the outcome of patients treated for AAI by isolated percutaneous transarticular screw fixation of C1/C2 (IPTSFC1/C2) using 3.5 mm fully threaded screws to identify its chances and limitations. In this retrospective study, data from patients who underwent IPTSFC1/C2 were analyzed. 23 patients (17 females and 6 males) with an average age of 73.1 years (y) were included. Mean VAS decreased significantly from preoperative 3.9 ± 1.8 to the last follow-up 2.6 ± 2.5 (p = 0.020) and neurological functions were preserved. In the radiological follow-up, we saw a single malposition of an inserted screw (2.27%) and one single bony fusion (4.54%). However, in 6 of 7 patients (85.71%), there was a loosening of the inserted screws due course. We demonstrated that the use of 3.5 mm fully threaded screws for IPTSFC1/C2 results in low rates of osseous fusions between C1 and C2. Therefore, their use in IPTSFC1/C2 is not suitable, especially for geriatric patients with impaired bone status.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 60%