C1-C2 transarticular screw fixation for atlantoaxial instability.
OBJECTIVE
The atlantoaxial segment of the cervical spine is commonly destabilized in a variety of disorders. Transarticular screw fixation of the C1-C2 joint has been proposed as a biomechanically superior therapeutic modality. The authors present their experience with this technique.


METHODS
A retrospective analysis of 23 patients treated with this technique was performed. The mean follow-up period was 39.5 +/- 0.1 months.


RESULTS
Mean duration of hospitalization was 3.4 +/- 0.1 days (range, 2 to 11 days). No intraoperative or early postoperative complications were detected. Four patients (17.4%) had postoperative complications unrelated to the primary procedure. The position of the screw was judged as satisfactory in 21 patients (91.3%). Two patients (8.7%) with suboptimal positioning of the screws were neurologically intact but needed no reoperation. Solid osseous fusion was detected in 19 patients (82.6%).


CONCLUSIONS
Transarticular C1-C2 screw fixation appears to be a safe and surgically reliable technique. Criteria for its application and refinements in its technical considerations continue to advance its clinically versatile therapeutic potential.
Fountas
K N
KN
Department of Neurosurgery and Radiology, The Medical Center of Central Georgia, Mercer University School of Medicine, Macon, GA, USA. knfountasmd@excite.com
Kapsalaki
E Z
EZ
Karampelas
I
I
Dimopoulos
V G
VG
Feltes
C H
CH
Kassam
M A
MA
Boev
A N
AN
Johnston
K W
KW
Smisson
H F
HF
Troup
E C
EC
Robinson
J S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001268:Atlanto-Axial Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D001696:Biomechanical Phenomena; D001863:Bone Screws / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies