title: Posterior C1-2 fusion using a polyaxial screw/rod system for os odontoideum with bilateral persistence of the first intersegmental artery.
abstract: The authors report the case of a patient with os odontoideum, myelopathy secondary to atlantoaxial instability, and bilaterally persistent first intersegmental artery at the craniovertebral junction. Instead of occipitocervical fusion, C1-2 posterior fusion was performed using a polyaxial screw/rod system. The information obtained from 3D CT angiography studies may highlight the potential risk of vertebral artery injury in advance and reduce the risk of an intraoperative vertebral artery injury. In addition, C-1 lateral mass screw placement may be a safe procedure for cases of atlantoaxial subluxation in which there are persistent C-1 intersegmental arteries.
authors.affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea. sobotta72@hotmail.com
authors.forename: Sun-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Eun-Sang
authors.initials: ES
authors.lastname: Kim
authors.forename: Whan
authors.initials: W
authors.lastname: Eoh
mesh_terms: D000328:Adult; D000792:Angiography; D001268:Atlanto-Axial Joint / Q000098:blood supply / Q000293:injuries / Q000601:surgery*; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000098:blood supply* / Q000293:injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007431:Intraoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008297:Male; D009460:Neurologic Examination; D009809:Odontoid Process / Q000098:blood supply* / Q000293:injuries / Q000601:surgery*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000002:abnormalities* / Q000293:injuries; D014741:Video Recording