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Journal of Korean Neurosurgical Society 2003;34(5): 491-494.
Posterior Atlantoaxial Fixation with Lateral Mass Screw in the Atlas and Pedicle Screw in the Axis.
Dong Ah Shin, Keung Nyun Kim, Do Heum Yoon
Department of Neurosurgery, College of Medicine, Yonsei University, Seoul, Korea. ydoheum@yumc.yonsei.ac.kr
The authors report the successful use of a recently described technique of posterior fixation of the C1 lateral mass and the C2 pedicle with polyaxial screws and rods. METHODS: After posterior exposure of the C1-C2 complex, the polyaxial screws were inserted into the lateral mass of C1 and the pedicle of C2 with the guidance of anatomic landmarks and fluoroscopy. Then, the pedicle screws of each side were linked with a rod. Because the C1-C2 pedicle screw fixation was sufficiently rigid, an additional posterior wiring or structural bone graft is unnecessary.
The early clinical and radiologic follow-up data indicated solid fusion of C1 and C2 vertebrae with no observed neural or vascular damage related to this technique. CONCLUSION: The posterior fixation of the C1-C2 complex using polyaxial screws and rods seems to be a reliable technique and an efficient alternative to the more commonly accepted procedures.
Key Words: Atlantoaxial instability; Atlantoaxial fixation; Polyaxial screw
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