C2 Laminar Screw Fixation

2019 ◽  
pp. 281-289
Author(s):  
Ilyas Aleem ◽  
Brad Currier
Keyword(s):  
Screw Fixation ◽  
Laminar Screw ◽  
C2 Laminar Screw

scholarly journals Atlantoaxial Stabilization Using C1 and C2 Laminar Screw Fixation

2017 ◽  
Vol 11 (2) ◽  
pp. 314-318 ◽  
Author(s):  
Takashi Tsuji ◽  
Kazuhiro Chiba ◽  
Yosuke Horiuchi ◽  
Tadahisa Urabe ◽  
Shota Fujita ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Lower Risk ◽  
Screw Fixation ◽  
Artery Occlusion ◽  
Cervical Spine Fracture ◽  
Atlantoaxial Joint ◽  
Laminar Screw ◽  
Combined Use ◽  
Atlantoaxial Stabilization ◽  
C2 Laminar Screw

<p>We describe the use of a C1 laminar screw in combination with a C2 laminar screw as a salvage technique to treat two patients, one with persistent first intersegmental artery and the other with vertebral artery occlusion after cervical spine fracture. The combined use of C1 and C2 laminar screws allows for good fixation of the atlantoaxial joint with a lower risk of vertebral artery injury; therefore, it can be an alternative surgical procedure for patients with congenital or traumatic anomalous vertebral artery.</p>

Clinical and radiologic outcome of laminar screw at C2 and C7 for posterior instrumentation—review of 25 cases and comparison of C2 and C7 intralaminar screw fixation

2010 ◽  
Vol 73 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Jae Taek Hong ◽  
Jin Seok Yi ◽  
Jong Tae Kim ◽  
Chul Ji ◽  
Kyung Sik Ryu ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Posterior Instrumentation ◽  
Laminar Screw

scholarly journals Posterior spinal fusion using a unilateral C1 posterior arch screw and a C2 laminar screw for atlantoaxial fracture dislocation

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984927 ◽  
Author(s):  
Yuichi Ono ◽  
Naohisa Miyakoshi ◽  
Michio Hongo ◽  
Yuji Kasukawa ◽  
Yoshinori Ishikawa ◽  
...  
Keyword(s):  
Pedicle Screws ◽  
Fracture Site ◽  
Fracture Dislocation ◽  
Posterior Arch ◽  
Lateral Mass ◽  
Laminar Screw ◽  
Upper Cervical ◽  
Lateral Mass Screws ◽  
The Right ◽  
C2 Laminar Screw

Introduction: C1 lateral mass screws and C2 pedicle screws are usually chosen to fix atlantoaxial (C1–C2) instability. However, there are a few situations in which these screws are difficult to use, such as in a case with a fracture line at the screw insertion point and bleeding from the fracture site. A new technique using a unilateral C1 posterior arch screw and a C2 laminar screw combined with a contralateral C1 lateral mass screws–C2 pedicle screws procedure for upper cervical fixation is reported. Case Report: A 24-year-old woman had an irreducible C1–C2 anterior dislocation with a type III odontoid fracture on the right side due to a traffic accident. The patient underwent open reduction and posterior C1–C2 fixation. On the left side, a C1 lateral mass screws and a C2 pedicle screws were placed. Because there was bleeding from the fracture site and a high-riding vertebral artery was seen on the right side, a C1 posterior arch screw and a C2 laminar screw were chosen. Eight months after the surgery, computed tomography scans showed healing of the odontoid fracture with anatomically correct alignment. Conclusions: Although there have been few comparable studies, fixation with unilateral C1 posterior arch screw–C2 laminar screw could be a beneficial choice for surgeries involving the upper cervical region in patients with fracture dislocation or arterial abnormalities.

P32. Significance of Laminar Screw Fixation in the Subaxial Cervical Spine

2008 ◽  
Vol 8 (5) ◽  
pp. 116S-117S ◽  
Author(s):  
Jae Taek Hong ◽  
Howard An ◽  
Chun-Kun Park ◽  
Sang Won Lee
Keyword(s):  
Cervical Spine ◽  
Screw Fixation ◽  
Laminar Screw ◽  
Subaxial Cervical Spine

scholarly journals Modified Trajectory of C2 Laminar Screw - Double Bicortical Purchase of the Inferiorly Crossing Screw

2008 ◽  
Vol 43 (2) ◽  
pp. 119 ◽  
Author(s):  
Woo-Tack Rhee ◽  
Seung-Hoon You ◽  
Yeon-Gyu Jang ◽  
Sang-Youl Lee
Keyword(s):  
Laminar Screw ◽  
C2 Laminar Screw

Significance of Laminar Screw Fixation in the Subaxial Cervical Spine

Spine ◽  
2008 ◽  
Vol 33 (16) ◽  
pp. 1739-1743 ◽  
Author(s):  
Jae Taek Hong ◽  
Jae Hoon Sung ◽  
Byung Chul Son ◽  
Sang Won Lee ◽  
Chun Kun Park
Keyword(s):  
Cervical Spine ◽  
Screw Fixation ◽  
Laminar Screw ◽  
Subaxial Cervical Spine

TRANSLAMINAR VERSUS PEDICLE SCREW FIXATION OF C2: COMPARISON OF SURGICAL MORBIDITY AND ACCURACY OF 313 CONSECUTIVE SCREWS

2009 ◽  
Vol 64 (suppl_5) ◽  
pp. ons343-ons349 ◽  
Author(s):  
Scott L. Parker ◽  
Matthew J. McGirt ◽  
Giannina L. Garcés-Ambrossi ◽  
Vivek A. Mehta ◽  
Daniel M. Sciubba ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Pedicle Screws ◽  
Patient Characteristics ◽  
Pedicle Screw Fixation ◽  
Cervical Fusion ◽  
Surgical Morbidity ◽  
Perioperative Morbidity ◽  
Computed Tomographic ◽  
Operative Revision ◽  
C2 Laminar Screw

Abstract OBJECTIVE C2 translaminar (TL) screws rigidly capture the posterior elements of C2, avoid risk of vertebral artery injury, and are less technically demanding than C2 pedicle (PD) screws. However, a C2-TL screw breach places the spinal cord at risk, and the durability of C2-TL screws remains unknown. It is unclear if TL versus PD screw fixation of C2 is truly associated with less operative morbidity, greater accuracy of screw placement, or equivalent durability. METHODS We retrospectively reviewed the records of 167 consecutive patients undergoing posterior cervical fusion with either PD or TL screw fixation of C2. Perioperative morbidity, breach of the C2 lamina or pedicle on postoperative computed tomographic scans, and rates of operative revision were compared between PD and TL screw constructs in axial (C1–C2 or C1–C3) and subaxial (C2 and caudal) cervical fusions. RESULTS In total, 152 C2-TL screws and 161 C2-PD screws were placed in 167 patients. Thirty-one (19%) cases of axial cervical fusion (C1–C2 or C1–C3) were performed (mean age, 63.8 ± 20.6 years) with either C2-TL (16 [52%]) or C2-PD (15 [48%]) screw fixation. One hundred thirty-six (81%) cases of subaxial cervical fusion (C2-caudal) were performed (mean age, 57.9 ± 14.7 years) with either C2-TL (66 [49%]) or C2-PD (70 [51%]) screw fixation. For both axial and subaxial cervical fusions, baseline patient characteristics and all measures of perioperative morbidity were similar between C2-TL and C2-PD screw cohorts. In total, 11 (7%) PD screws breached the pedicle (0 requiring acute revision) versus only 2 (1.3%) TL screws that breached the C2 lamina (1 requiring acute revision) (P = 0.018). By 1 year postoperatively, pseudoarthrosis or screw pullout requiring reoperation was required in 4 (6.1%) patients with C2-TL screws versus 0 (0%) patients with PD screws (P &lt; 0.05 for subaxial constructs). No cases of C2-TL or C2-PD axial fusion required reoperation or screw pullout or pseudoarthrosis. CONCLUSION In our experience, radiographic breach of C2 pedicle screws occurred more frequently than C2 laminar screw breach. However, this was not associated with an increase in morbidity. By 12 months postoperatively, C2-TL screws were associated with a greater incidence of operative revision when used in subaxial constructs but similarly effective for axial cervical constructs. The 1-year durability of C2-TL screws might be inferior to C2 pedicle screws for subaxial fusions, but equally effective for axial cervical fusions.

Biomechanical Effect of the C2 Laminar Decortication on the Stability of C2 Intralaminar Screw Construct and Biomechanical Comparison of C2 Intralaminar Screw and C2 Pars Screw

2011 ◽  
Vol 69 (suppl_1) ◽  
pp. ons1-ons7 ◽  
Author(s):  
Jae Taek Hong ◽  
Tomoyuki Takigawa ◽  
Ranjith Udayakunmar ◽  
Hun Kyu Shin ◽  
Peter Simon ◽  
...  
Keyword(s):  
Axial Rotation ◽  
Insertion Torque ◽  
Lateral Mass ◽  
Pullout Strength ◽  
Lateral Bending ◽  
Biomechanical Stability ◽  
Laminar Screw ◽  
Flexion Extension ◽  
The Stability ◽  
C2 Laminar Screw

Abstract BACKGROUND: There have been no reports of biomechanical stability of C1-2 constructs after decortication of the C2 lamina. In addition, few studies have compared the stability of C2 laminar screw and pars screw constructs. OBJECTIVE: To compare the biomechanical stability of 3 different C1-2 construct conditions (C2 pars screw, C2 intralaminar screw, C2 intralaminar construct with C2 laminar decortication). METHODS: Fourteen fresh-frozen cadaveric cervical specimens (C1-3) were used. In 7 specimens, pure moments of 1.5 Nm were applied in flexion/extension, lateral bending, and axial rotation. Each specimen was tested in the normal state, in the destabilized state (after odontoidectomy and resection of transverse atlantal ligament), and after application of constructs. After kinematic study, these 7 specimens underwent axial pullout strength testing of pars screw and 50% decorticated C2 intralaminar screws. In another 7 specimens, insertion torque and pullout strength were measured to compare the pars screw and intact C2 intralaminar screw. RESULTS: There were no statistically significant differences between the intact C2 intralaminar and 50% decorticated C2 intralaminar screw constructs in terms of range-of-motion limitations. The C2 pars screw construct was significantly superior to the C2 laminar screw construct in lateral bending (P &lt; .01) and axial rotation (P &lt; .01) and equivalent to the C2 laminar screw construct in flexion/extension (P = .42). There was no significant pullout strength difference between the 3 kinds of C2 screw. CONCLUSION: The C1 lateral mass-C2 pars screws construct was stronger than the C1 lateral mass-C2 intralaminar screw construct. Decortication of C2 laminar (up to 50%) did not affect the immediate stability of the C1-2 construct.

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