Open AccessAnterior transarticular screw fixation for atlantoaxial arthrodesis: A report of two cases
Author(s) -
Carrier Cs,
Sama Aa,
Girardi Fp,
Lebl Dr
Publication year - 2013
Publication title -
journal of craniovertebral junction and spine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.38
H-Index - 23
eISSN - 0976-9285
pISSN - 0974-8237
DOI - 10.4103/0974-8237.128540
Subject(s) - medicine , atlantoaxial instability , decortication , surgery , arthrodesis , neck pain , fixation (population genetics) , cervical spine , population , alternative medicine , environmental health , pathology
The sequelae of atlantoaxial instability (AAI) range from axial neck pain to life-threatening neurologic injury. Instrumentation and fusion of the C1-2 joint is often indicated in the setting of clinical or biomechanical instability. This is the first clinical report of anterior Smith-Robinson C1-2 transarticular screw (TAS) fixation for AAI. The first patient presented with ischemic brain tissue secondary to post-traumatic C1-2 segment instability from a MVC 7 years prior to presentation. The second patient presented with a 3 year history of persistent right-sided neck and upper scalp pain. Both were treated with transarticular C1-2 fusion through decortication of the atlantoaxial facet joints and TAS fixation via the anterior Smith-Robinson approach. At 16 months follow-up, the first patient maintained painless range of motion of the cervical spine and denied sensorimotor deficits. The second patient reported 90% improvement in her pre-operative symptoms of neck pain and paresthesia. Anterior Smith-Robinson C1-2 TAS fixation provides a useful alternative to the posterior Goel and Magerl techniques for C1-2 stabilization and fusion.