Safety Issues and Neurological Improvement following C1-C2 Fusion using C1 Lateral Mass and C2 Pedicle Screw in Atlantoaxial Instability
Abstract
The evolution of instrumentation methods for C1-C2 fusion from the use of posterior wiring methods to transarticular screws and C1 lateral mass with C2 pedicle screw construct have improved fusion rates to almost 100%. However, the C1 lateral mass and C2 pedicle screw technique is technically demanding. This is a prospective review of a series of ten patients who was planned for C1-C2 fusion using C1 lateral mass and C2 pedicle screw technique between January 2007 and June 2009. The procedure was converted to occipital cervical fusion due to a fracture of a hypoplastic lateral mass-posterior arch complex in one patient and Gallie fusion due to a vertebral artery injury in another. Eight patients underwent the C1-C2 fusion using C1 lateral mass and C2 pedicle screw successfully without any complications. The union rate was 100% with an average union time of 5.3 months (range from 3 to 8 months). Postoperatively, the patients achieved an average of one Frankel grade neurological improvement. In conclusion, this technique provides an excellent union rate and good neurological recovery.
Abstract | Reference
