title: Atlantoaxial stabilization utilizing atlas translaminar fixation.
abstract: Atlantoaxial instability is a potentially devastating sequela of tumor invasion to the upper cervical spine. We aim to report an alternative technique for atlantoaxial stabilization. Stabilization is technically demanding due to limited bony elements and proximity of the regional neurovascular structures. While the C1 lateral masses are considered robust points of fixation, one or both of these structures may be destroyed by pathology. A 54-year-old female presented with a lytic, metastatic lesion to one of the C1 lateral masses, which precluded its use for fixation. We utilized the contralateral hemilamina of the atlas for screw fixation and devised a stable construct that provided immediate stability. Thus, atlas translaminar fixation is a feasible option when the lateral masses cannot be utilized.
authors.affiliation: Department of Neurosurgery, College of Medicine, University of South Florida, Tampa, Florida 33606, USA. abaaj@hsc.usf.edu
authors.forename: Ali A
authors.initials: AA
authors.lastname: Baaj
authors.forename: Frank D
authors.initials: FD
authors.lastname: Vrionis
mesh_terms: D001268:Atlanto-Axial Joint / Q000601:surgery*; D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery*; D001863:Bone Screws; D001943:Breast Neoplasms / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000556:secondary; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods*