The Comparison Between Transarticular Screw Fixation and Segmental Screw-Rod Fixation for Posterior Fusion of the C1-2 Segment: A Systematic Review and Meta-Analysis

Chang, Min Cheol; Seok, Hyun-Gyu; Choo, Yoo Jin; Lee, Gun Woo

doi:10.1016/j.wneu.2022.05.086

Cited by 5 publications

(5 citation statements)

References 30 publications

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“…A recent meta-analysis that compared TAS and SRC for C1-C2 fusion demonstrated that SRC had higher fusion rates (OR: 2.96) with a lower risk of vertebral artery injury. 32 These findings were similar to a previous meta-analysis which found a slightly lower rate of fusion in TAS and an increased rate of vertebral artery injury and screw misplacement. 31 As both meta-analyses found, TAS seems to be a more challenging operation with a higher risk of vertebral artery injury.…”

Section: Evidence For Surgical Managementsupporting

confidence: 91%

Evidence and Controversies in Geriatric Odontoid Fracture Management

Goh,

Issa,

Lee

et al. 2023

J Am Acad Orthop Surg

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Geriatric odontoid fractures are some of the most common spine injuries in our aging population, and their prevalence is only continuing to increase. Despite several investigational studies, treatment remains controversial and there is limited conclusive evidence regarding the management of odontoid fractures. These injuries typically occur in medically complex and frail geriatric patients with poor bone quality, making their treatment particularly challenging. In this article, we review the evidence for conservative management as well as surgical intervention and discuss various treatment strategies. Given the high morbidity and mortality associated with odontoid fractures in the elderly, thoughtful consideration and an emphasis on patient-centered goals of treatment are critical to maximize function in this vulnerable population.

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Section: Evidence For Surgical Managementsupporting

confidence: 91%

Evidence and Controversies in Geriatric Odontoid Fracture Management

Goh,

Issa,

Lee

et al. 2023

J Am Acad Orthop Surg

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“…In 2022, Soliman MAR et al [ 22 ] carried out a meta-analysis including 1768 patients and 8636 spinal fusion screws and investigated the complications correlated with subaxial placement of translaminar versus lateral screws in the cervical spine, showing no differences between them. In the same year, Chang MC group [ 23 ] performed a meta-analysis of 5101 publications comparing transarticular screw fixation versus segmental screw-rod fixation at the C1–C2 level, leading to segmental spinal fusion exhibiting a lower risk of vascular complications.…”

Section: Resultsmentioning

confidence: 99%

Incidence of vertebral artery injury in patients undergoing cervical spine trauma surgery in correlation with surgical approach: A review

Sakellariou,

Benetos,

Evangelopoulos

et al. 2023

Medicine

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Spinal cord injuries at the cervical spine level represent the most consequential of the related injuries at all levels of the spine. They can trigger permanent unilateral or bilateral damage with conspicuous disability. Regarding unstable injuries, the gold standard approach is open reduction and osteosynthesis, which can select between anterior and posterior surgical access. Each of the aforementioned approaches demonstrates both advantages and disadvantages; thus, it is up to the surgeon to determine the optimal option concerning the patient’s safety. Diligent intraoperative control of anatomical reduction is pivotal to obtaining the best feasible postoperative outcomes. Literature data delineate copious complications following surgical intervention in the cervical spine. Indubitably, the most crucial intraoperative complication accounts for vascular injuries, with the most preponderant being the corrosion of the vertebral artery, as it is potentially life-threatening. This paper aims to provide a succinct and compendious review of the existing literature regarding cervical spinal cord injuries and to deduce many inferences concerning the incidence of iatrogenic vertebral artery injuries in relation to the surgical approach for fracture reduction.

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“…In 2022, a comparative meta-analysis assessing the e cacy of GHT versus TAF [7] concluded with the Goel-Harms method being deemed safer and more effective. This study also suggested adopting the Goel-Harms technique for craniovertebral junction surgeries as a guideline for surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…However, the literature lacks comparative studies with robust evidence. The sole comparative meta-analysis [7], which included cases from both TAF and GHT, did not incorporate all available studies, selecting only 6 out of 16 published papers. This selective inclusion has led to publication bias and potentially awed conclusions.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Meta-Analysis of Implant-Related Complications and Fusion Rates for the Atlantoaxial Fusion with Transarticular Screws and Screw-Rod Constructs.

Lvov,

Grin,

Talypov

et al. 2024

Preprint

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Objectives. This study aims to conduct a comparative meta-analysis on the frequency of implant-related complications and fusion rates between screw-rod C1-C2 fusion (Goel-Harms technique, GHT) and transarticular atlantoaxial fusion (Magerl technique, TAF). Methods. Following PRISMA guidelines, we conducted a systematic review. An initial search in the PubMed database yielded over 5,000 abstracts. Inclusion criteria were articles in English involving both TAF and GHT, patient age over 18 years, and studies reporting on fusion incidence and/or implant-related complications, published since January 1987. Results. Sixteen studies met the inclusion criteria. The analysis revealed no significant differences in surgery duration (SMD = -0.21, 95% CI [-0.79, 0.37]) or intraoperative blood loss volume (SMD = 0.095, 95% CI [-0.41, 0.60]). Furthermore, no significant differences were observed between GHT and TAF concerning vertebral artery (VA) injury rate (OR 0.55, 95% CI [0.23 – 1.21]), screw malposition with VA canal perforation (OR 0.77, 95% CI [0.25 – 2.40]), screw malposition in other directions (OR 0.89, 95% CI [0.23-3.44]), C2 radiculopathy (OR 1.3, 95% CI [0.3 – 5.7]), implant failure (OR 0.49, 95% CI [0.16 – 1.46]), and fusion development (OR 1.97, 95% CI [0.93 – 4.16]). Begg's test indicated no publication bias. Conclusion. This meta-analysis found no significant differences between the Goel-Harms and Magerl methods regarding operation duration, intraoperative blood loss, the incidence of postoperative implant-related complications, and C1-C2 fusion rates. Further research, especially studies with a higher evidence level, is vital to develop guidelines for the most effective atlantoaxial stabilization method.

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The Comparison Between Transarticular Screw Fixation and Segmental Screw-Rod Fixation for Posterior Fusion of the C1-2 Segment: A Systematic Review and Meta-Analysis

Cited by 5 publications

References 30 publications

Evidence and Controversies in Geriatric Odontoid Fracture Management

Evidence and Controversies in Geriatric Odontoid Fracture Management

Incidence of vertebral artery injury in patients undergoing cervical spine trauma surgery in correlation with surgical approach: A review

A Comparative Meta-Analysis of Implant-Related Complications and Fusion Rates for the Atlantoaxial Fusion with Transarticular Screws and Screw-Rod Constructs.

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