Transarticular Screw and C1 Hook Fixation for Os Odontoideum with Atlantoaxial Dislocation

Ni, Bin; Zhou, Fang; Xie, Ning; Guo, Xiang; Yang, Lili; Guo, Qunfeng; Yang, Jian; Li, Songkai; Zhang, Feng; Zhu, Zhuangchen; Chen, Jinshui

doi:10.1016/j.wneu.2010.07.021

Cited by 20 publications

(13 citation statements)

References 30 publications

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“…This modified technique is easier and less invasive than sublaminar wiring because the posterior arch of C1 does not need to be exposed. 13 Additionally, this three-point fixation provides high biomechanical stability while also preserving the ligamentous tissue between C2 and C3. However, $20% of patients requiring atlantoaxial fusion have anatomical variations that would interfere with safe placement of transarticular screws and must undergo a different fusion technique.…”

Section: Historical Methodsmentioning

confidence: 99%

“…12,[86][87][88] Sublaminar wiring has also been implicated as a cause of neural injury and disruption of ligamentous tissue that supports the spinal column. 13 Posterior wiring may still be used for secondary fixation with transarticular screws in certain salvage procedures, 89 or in cases with highly abnormal anatomy. The Magerl technique, or C1-C2 transarticular screw fixation with posterior wiring, was first described in 1986 and became popular for cervical fixations including treatment of atlantoaxial dislocation because of its superior biomechanical strength and high fusion rates compared with posterior wiring, 12 with fusion rates as high as 100% reported.…”

Section: Historical Methodsmentioning

confidence: 99%

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A Review of the Diagnosis and Treatment of Atlantoaxial Dislocations

Yang

Boniello

Poorman

et al. 2014

Global Spine Journal

167

218

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Study Design Literature review. Objective Atlantoaxial dislocation (AAD) is a rare and potentially fatal disturbance to the normal occipital-cervical anatomy that affects some populations disproportionately, which may cause permanent neurologic deficits or sagittal deformity if not treated in a timely and appropriate manner. Currently, there is a lack of consensus among surgeons on the best approach to diagnose, characterize, and treat this condition. The objective of this review is to provide a comprehensive review of the literature to identify timely and effective diagnostic techniques and treatment modalities of AAD. Methods This review examined all articles published concerning “atlantoaxial dislocation” or “atlantoaxial subluxation” on the PubMed database. We included 112 articles published between 1966 and 2014. Results Results of these studies are summarized primarily as defining AAD, the normal anatomy, etiology of dislocation, clinical presentation, diagnostic techniques, classification, and recommendations for timely treatment modalities. Conclusions The Wang Classification System provides a practical means to diagnose and treat AAD. However, future research is required to identify the most salient intervention component or combination of components that lead to the best outcomes.

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Section: Historical Methodsmentioning

confidence: 99%

Section: Historical Methodsmentioning

confidence: 99%

A Review of the Diagnosis and Treatment of Atlantoaxial Dislocations

Yang

Boniello

Poorman

et al. 2014

Global Spine Journal

167

218

View full text Add to dashboard Cite

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“…Recently, some authors suggested the use of a combination of a C1-C2 transarticular screw and a C1 hook instead of Gallie fusion (Fig. 7) [15,16], whereas others reported that additional internal fixation was not required [17]. It has been reported that this modification avoided the potential risk of spinal cord injury caused by the passage of sublaminar wires.…”

Section: Atlantoaxial Transarticular Screw Techniquementioning

confidence: 99%

“…7) is actually a modification of Magerl's transarticular screw fixation technique, which combines the C1 hooks instead supplementing with Gallie fusion [15,16]. Recently, Guo et al [16] reported excellent long-term outcomes of a case series treated by this technique.…”

Section: C1 Hook Combined With C1-c2 Transarticular Screwmentioning

confidence: 99%

Posterior atlantoaxial fixation: a review of all techniques

et al. 2015

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“…The intrinsic stability of the atlantoaxial complex is provided by the dens apophysis, which binds to the ventral osteoligamentous ring, formed by the anterior arch of the atlas, and dorsally by the transverse ligament. 2,6,11 The transverse ligament and facet joint capsule impede the anterior translation of C1 on C2. The alar ligaments connect to the posterolateral apex of the dens with the lateral aspect of the magnum foramen bilaterally, which limits particularly anterior displacement of the atlas in the dens and excessive rotation of C1 on C2.…”

Section: Discussionmentioning

confidence: 99%

Traumatic atlantoaxial subluxation, posterior transfacet fixation: a case report

2015

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Cervical spine injuries are often described as catastrophic events in neurological terms, with very low survival rate. Lesions to C3-C7 segment are the most common (about 80%) followed by segment C1-C2 (20%). The cervical spine injuries are of great importance, both by severity as the neurological implications. It is important to consider that among cervical traumas that do not present neurological damage at the time of the accident, 10% have deficits later, so all cervical trauma should be considered as potential spinal cord traumas, until the evolution of the case shows that definitively there is no spinal cord or nerve root damage. Cases have been reported with both atlantooccipital and atlantoaxial dislocations without neurological deficit, so these lesions went unnoticed in the emergency services. Some of the events to be considered at the time of the accident are suboccipital pain on axial skull pressure and spontaneous stiffness of the patient's neck. Dysphagia, pain on palpation of the anterior neck and a visible increase of prepharyngeal mass can also be observed, which is why it is important to keep the suspicion of craniocervical trauma in all patients who have these symptoms and carry out the relevant tests. This paper presents a case of post-traumatic atlantoaxial dislocation, which showed no neurological deficit at the time of the accident, but was later presented, as well as the surgical procedure carried out.

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Transarticular Screw and C1 Hook Fixation for Os Odontoideum with Atlantoaxial Dislocation

Cited by 20 publications

References 30 publications

A Review of the Diagnosis and Treatment of Atlantoaxial Dislocations

A Review of the Diagnosis and Treatment of Atlantoaxial Dislocations

Posterior atlantoaxial fixation: a review of all techniques

Traumatic atlantoaxial subluxation, posterior transfacet fixation: a case report

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