Feasibility of C2 translaminar screw as an alternative or salvage of C2 pedicle screws in atlantoaxial instability.
J Spinal Disord Tech
; 25(5): 254-8, 2012 Jul.
Article
em En
| MEDLINE
| ID: mdl-21666509
ABSTRACT
STUDY DESIGN:
A retrospective outcome study.OBJECTIVE:
The purpose of this study was to analyze the clinical outcomes of our experience with the C2 translaminar screw technique and evaluate its feasibility as an alternative or salvage of the pedicle screw. SUMMARY OF BACKGROUND DATA Pedicle screws are the most biomechanically stable screws for use in atlantoaxial fixation. However, in cases with elevated risk of neurovascular complications or failure of screw insertion attempts, a reliable alternative technique is required.METHODS:
Fourteen patients with atlantoaxial instability underwent posterior fixation with C2 translaminar screws. Indications included traumatic instability, atlantoaxial subluxation, os odontoideum, and fusion failure after anterior fixation of a type II odontoid process fracture. A total of 26 screws were inserted and all patients were assessed both clinically and radiographically.RESULTS:
No procedure-related complications or hardware failures were observed during the follow-up. Postoperative computed tomographic scans revealed laminar breach in 3 patients and none of these resulted in neurological symptoms. Radiographically demonstrated bony fusion was established in 11 patients (91.7%) at follow-up over 6 months, and 5 patients with initial neurological deficit demonstrated at least 1 grade improvement by Frankel grade.CONCLUSIONS:
C2 translaminar screws provide surgeons with an expanded option for posterior fusion in high cervical lesions. This technique is safe and easy to adopt with a favorable rate of successful fusion. We believe that preoperative planning using computed tomographic scan is mandatory and use of an additional connector may reduce the stress and strain of the screws.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Articulação Atlantoaxial
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Fusão Vertebral
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Vértebra Cervical Áxis
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Parafusos Ósseos
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Fraturas da Coluna Vertebral
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Instabilidade Articular
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Spinal Disord Tech
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Coréia do Sul