Anatomical evaluation of the groove for the vertebral artery in the axis vertebrae for atlanto-axial transarticular screw fixation technique

2000 ◽  
Vol 13 (4) ◽  
pp. 237-243 ◽  
Author(s):  
Saim Kazan ◽  
Fato? Yildirim ◽  
Muzaffer Sindel ◽  
Recai? Tuncer
Keyword(s):  
Vertebral Artery ◽  
Screw Fixation ◽  
Fixation Technique ◽  
Transarticular Screw ◽  
Transarticular Screw Fixation

Atlantoaxial Transarticular Screw Fixation for a High-Riding Vertebral Artery

Spine ◽  
2003 ◽  
Vol 28 (7) ◽  
pp. 666-670 ◽  
Author(s):  
Masashi Neo ◽  
Mutsumi Matsushita ◽  
Yasushi Iwashita ◽  
Tadashi Yasuda ◽  
Takeshi Sakamoto ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Screw Fixation ◽  
Transarticular Screw ◽  
Transarticular Screw Fixation

Arteriovenous fistula as a complication of C1–2 transarticular screw fixation

1996 ◽  
Vol 85 (2) ◽  
pp. 340-343 ◽  
Author(s):  
Domagoj Coric ◽  
Charles L. Branch ◽  
John A. Wilson ◽  
James C. Robinson
Keyword(s):  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Screw Fixation ◽  
Atlantoaxial Instability ◽  
Unusual Complication ◽  
Venous Plexus ◽  
Fixation Technique ◽  
Transarticular Screw ◽  
Content Type ◽  
Transarticular Fixation

✓ A case is reported of a vertebral artery-to-epidural venous plexus fistula as a complication of posterior atlantoaxial facet screw fixation. The use of transarticular screws to stabilize the C1–2 joint has become an increasingly popular fixation technique, most notably for atlantoaxial instability due to trauma or rheumatoid disease. Despite the fact that this approach is technically challenging, there have been few reports of complications associated with C1–2 transarticular fixation. Although damage to the vertebral artery is a documented hazard of transarticular fixation at this level, a symptomatic arteriovenous fistula resulting from the procedure has not been described previously. The etiology, presentation, and treatment of this unusual complication are discussed.

Biomechanical Comparison of Two Atlantoaxial Arthrodeses in a Cadaveric Spine Model: Transarticular Screw Fixation Versus Screw and Rod Fixation

2002 ◽  
Author(s):  
V. K. Goel ◽  
H. Kuroki ◽  
S. Holekamp ◽  
V. Pitka¨nen ◽  
S. Rengachary ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Screw Fixation ◽  
Atlantoaxial Instability ◽  
Transarticular Screw ◽  
Transarticular Screw Fixation ◽  
Risk Of Injury ◽  
Spine Model ◽  
Fixation Techniques ◽  
A New Technique ◽  
Biomechanical Comparison

The causes of atlantoaxial instability include trauma, tumor, congenital malformation, or rheumatoid arthritis. Commonly available fixation techniques to stabilize the atlantoaxial complex are several posterior wiring procedures (Brooks fusion, Gallie fusion), transarticular screw procedure (Magerl technique), either alone or in combination. Wiring procedures are obviously easier to accomplish however these do not provide sufficient immobilization across the atlantoaxial complex1,3,4. On the other hand, although transarticular screw fixation (TSF) affords a much stiffer atlantoaxial arthrodesis than posterior wiring procedures. However, TSF has some drawbacks; for example the injury of vertebral artery. Furthermore, body habitus (obesity or thoracic kyphosis) may prevent from achieving the low angle needed for correct placement of screws between C1 and C2. Recently, a new technique of screw and rod fixation (SRF) that minimizes the risk of injury to the vertebral artery and allows intraoperative reduction has been reported2,6. The purpose of this study was to compare the biomechanical stability imparted to the C1 and C2 vertebrae by either TSF or SRF technique in a cadaver model.

scholarly journals Reducible Nonunited Type II Odontoid Fracture with Atlantoaxial Instability: Outcomes of Two Different Fixation Techniques

2021 ◽  
Vol 18 (15) ◽  
pp. 7990
Author(s):  
Torphong Bunmaprasert ◽  
Vorapop Trirattanapikul ◽  
Nantawit Sugandhavesa ◽  
Areerak Phanphaisarn ◽  
Wongthawat Liawrungrueang ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Fusion Rate ◽  
Odontoid Fracture ◽  
Atlantoaxial Instability ◽  
Type Ii ◽  
Fixation Technique ◽  
Transarticular Screw ◽  
Transarticular Screw Fixation ◽  
Fixation Techniques ◽  
Surgical Fixation

Displaced nonunited type II odontoid fracture can result in atlantoaxial instability, causing delayed cervical myelopathy. Both Magerl’s C1-C2 transarticular screw fixation technique and Harms-Goel C1-C2 screw-rod segmental fixation technique are effective techniques to provide stability. This study aimed to demonstrate the results of two surgical fixation techniques for the treatment of reducible nonunited type II odontoid fracture with atlantoaxial instability. Medical records of patients with reducible nonunited type II odontoid fracture hospitalized for spinal fusion between April 2007 and April 2018 were reviewed. For each patient, specific surgical fixation, either Magerl’s C1-C2 transarticular screw fixation technique augmented with supplemental wiring or Harms-Goel C1-C2 screw-rod fixation technique, was performed according to our management protocol. We reported the fusion rate, fusion period, and complications for each technique. Of 21 patients, 10 patients were treated with Magerl’s C1-C2 transarticular screw fixation technique augmented with supplemental wiring, and 11 were treated with Harms-Goel C1-C2 screw-rod fixation technique. The bony fusion rate was 100% in both groups. The median time to fusion was 69.7 (95%CI 53.1, 86.3) days in Magerl’s C1-C2 transarticular screw fixation technique and 75.2 (95%CI 51.8, 98.6) days in Harms-Goel C1-C2 screw-rod fixation technique. No severe complications were observed in either group. Displaced reducible, nonunited type II odontoid fracture with cervical myelopathy should be treated by surgery. Both fixation techniques promote bony fusion and provide substantial construct stability.

Transarticular Fixation Following Mobilization of “High-Riding” Vertebral Artery

2021 ◽  
Author(s):  
Atul Goel ◽  
Apurva Prasad ◽  
Abhidha Shah ◽  
Sumeet Sasane ◽  
Akshay Hawaldar ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Screw Fixation ◽  
Basilar Invagination ◽  
Transarticular Screw ◽  
Posterior Aspect ◽  
Screw Insertion ◽  
Transarticular Screw Fixation ◽  
History Of ◽  
C2 Vertebra ◽  
Transarticular Fixation

Abstract BACKGROUND AND IMPORTANCE: The article identifies the feasibility of transarticular screw fixation after mobilizing the vertebral artery in cases where it is in a “high-riding” location. CLINICAL PRESENTATION: A 42-yr-old male patient had a 4-yr history of progressive quadriparesis. Investigations revealed severe basilar invagination. There was assimilation of atlas and C2-3 fusion. The vertebral artery was “high-riding” into the pedicle-facet of C2 vertebra on both sides. Vertebral artery loop was exposed and mobilized inferiorly on both sides after careful drilling of pedicular bone on the posterior aspect of the dome of the artery. C2 facetal bone on the anterior face of the vertebral artery dome was now available for screw insertion. The C1-2 facets and the articulation were directly in line, making transarticular screw fixation relatively straightforward. The wide bone space available permitted insertion of 2 screws in a transarticular fashion on both sides. The patient had satisfactory clinical improvement. Imaging after 22 mo showed bone fusion across the facets. CONCLUSION: Mobilization of the high-riding vertebral artery loop can help salvage the surgical procedure of lateral mass stabilization.

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