The interspinous method of posterior atlantoaxial arthrodesis.
Thirty-six patients underwent C1-2 posterior wiring and fusion procedures over a 5-year period for unstable C-2 fractures (eight cases), unstable atlas-axis combination fractures (six cases), rheumatoid C1-2 instability (14 cases), os odontoideum (four cases), traumatic C1-2 ligamentous instability (three cases), or instability secondary to a C-2 tumor (one case). In each case, the atlantoaxial arthrodesis utilized sublaminar wire at C-1 and incorporated an iliac-crest strut-graft positioned between the posterior arches of C-1 and C-2, held in place by securing wire around the base of the spinous process of the axis. Follow-up examination was performed in all patients after a mean postoperative duration of 33.7 months. The technical aspects and clinical merits of this fusion procedure, which led to a 97% union rate (one nonunion) and minimal morbidity and mortality rates, are presented.
Dickman
C A
CA
Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.
Sonntag
V K
VK
Papadopoulos
S M
SM
Hadley
M N
MN
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography