title: Outcomes of C1 and C2 posterior screw fixation for upper cervical spine fusion.
abstract: To achieve stable fixation of the upper cervical spine in posterior fusions, the occiput is often included. With the newer techniques, excluding fixation to the occiput will retain the occiput-cervical motion, while still allowing a stable fixation. Harms's technique has been adapted at our institution and its effectiveness for indications such as C2 complex fractures and tumors using C1 or C2 as endpoints of a posterior fixation are reviewed. Fourteen cases were identified, consisting of one os odontoideum; four acute fractures and four non-unions of the odontoid; three tumors and two complex fractures of C2 vertebral body, and one C2-C3 post-traumatic instability. One misplaced screw without clinical consequences was the only complication recorded. Screw loosening or migration was not observed at follow-up, showing a stable fixation.
authors.affiliation: Department of Orthopedics, Traumatology and Spine Surgery, Ospedale Maggiore C.A. Pizzardi AUSL Bologna, Largo Nigrisoli 2, Bologna 40100, Italy. federicodeiure@acantho.it
authors.forename: F
authors.initials: F
authors.lastname: De Iure
authors.forename: R
authors.initials: R
authors.lastname: Donthineni
authors.forename: S
authors.initials: S
authors.lastname: Boriani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; 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 / Q000706:statistics & numerical data*; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D007796:Laminectomy / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome