New entry point for C2 screw, in posterior C1-C2 fixation (Goel-Harm's technique) significantly reducing the possibility of vertebral artery injury.
OBJECTIVE
To reduce the chance of vertebral artery injury in posterior C1 lateral mass and C2 pedicle/pars screw-rod fixation (Goel-Harms technique ).


METHODS
49 patients, 30 males and 19 females, 12years - 82 years, underwent posterior C1-C2 fixation from February 2007 till June2013. A new entry point for the posterior C2 screw, 3mm below the midpoint of the C1-C2 joint which is directed medially and downwards into the C2 body , probably avoids the vertebral artery. As the screw now bypasses the pedicle/ pars , the chance of injuring the vertebral artery is probably reduced.


RESULTS
No case of intra-operative vertebral artery injury.


CONCLUSIONS
The new technique of C2 screw fixation allows rigid immobilization of the C1-C2 joint without significant risk of vertebral artery injury.
a Poona Hospital & Research Centre , Bharati Vidyapeeth Medical College , Pune , India.
Sushil Vasant
SV
Patkar
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000601:surgery*; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult
Atlanto - Axial Dislocation; Atlanto - Axial Fixation; Axis pars screw; Axis pedicle screw; Vertebral artery injury