title: Atlantoaxial stabilization using multiaxial C-1 posterior arch screws.
abstract: The authors present a novel technique of atlantoaxial fixation using multiaxial C-1 posterior arch screws. The technique involves the insertion of bilateral multiaxial C-1 posterior arch screws, which are connected by crosslinked rods to bilateral multiaxial C-2 pars screws. The clinical results are presented in 3 patients in whom anomalies of the vertebral arteries, C-1 lateral masses, and/or posterior arch of C-1 presented difficulty using existing fixation techniques with transarticular screws, C-1 lateral mass screws, or posterior wiring. The C-1 posterior arch screws achieved solid fixation and their insertion appeared to be technically less demanding than that of transarticular or C-1 lateral mass screws. This technique may reduce the risk of complications compared with existing techniques, especially in patients with anatomical variants of the vertebral artery, C-1 lateral masses, or C-1 posterior arch. This technique may prove to be an attractive fixation option in patients with normal anatomy.
authors.affiliation: Department of Neurosurgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Donnellan
authors.forename: Ioannis G
authors.initials: IG
authors.lastname: Sergides
authors.forename: William R
authors.initials: WR
authors.lastname: Sears
mesh_terms: D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint; D001863:Bone Screws; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation*