title: C1-C2 transarticular screw fixation for atlantoaxial instability.
abstract: 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.
authors.affiliation: Department of Neurosurgery and Radiology, The Medical Center of Central Georgia, Mercer University School of Medicine, Macon, GA, USA. knfountasmd@excite.com
authors.forename: K N
authors.initials: KN
authors.lastname: Fountas
authors.forename: E Z
authors.initials: EZ
authors.lastname: Kapsalaki
authors.forename: I
authors.initials: I
authors.lastname: Karampelas
authors.forename: V G
authors.initials: VG
authors.lastname: Dimopoulos
authors.forename: C H
authors.initials: CH
authors.lastname: Feltes
authors.forename: M A
authors.initials: MA
authors.lastname: Kassam
authors.forename: A N
authors.initials: AN
authors.lastname: Boev
authors.forename: K W
authors.initials: KW
authors.lastname: Johnston
authors.forename: H F
authors.initials: HF
authors.lastname: Smisson
authors.forename: E C
authors.initials: EC
authors.lastname: Troup
authors.forename: J S
authors.initials: JS
authors.lastname: Robinson
mesh_terms: 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