Double insurance atlantoaxial fixation.
BACKGROUND
An alternative technique of atlantoaxial fixation is described, which combines the trans-articular method of fixation described by Magerl in 1982 and the interarticular technique described by us in 1988.


METHODS
Between January 2001 and January 2005, 18 patients underwent the discussed method of fixation at the Department of Neurosurgery at King Edward VII Memorial Hospital in Mumbai, India. Fifteen patients had congenital craniovertebral anomaly and 3 patients had posttraumatic atlantoaxial instability. Fourteen patients had basilar invagination with "fixed" atlantoaxial dislocation, and 4 patients had mobile and reducible atlantoaxial dislocation. The mean follow-up period was 22 months (range, 3-50 months).


RESULTS
Successful atlantoaxial stabilization was achieved in all patients and was documented with dynamic radiography. There was no incidence of implant rejection. There were no neurological, vascular, or infective complications.


CONCLUSIONS
The described method of atlantoaxial fixation that incorporates the advantages of the 2 currently more frequently used techniques of lateral mass fixation could be an alternative method of fixation.
Goel
Atul
A
Department of Neurosurgery, King Edward VII Memorial Hospital, Mumbai-400012, India. atulgoel62@hotmail.com
D000293:Adolescent; D000328:Adult; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001863:Bone Screws / Q000592:standards / Q000639:trends; D016025:Bone Transplantation; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000592:standards / Q000639:trends*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D011183:Postoperative Complications; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000473:pathology / Q000601:surgery