The height for screw index (HSI) predicts the development of C2 nerve dysfunction associated with C1 lateral mass screw fixation for atlantoaxial instability

2014 ◽  
Vol 23 (5) ◽  
pp. 1092-1098 ◽  
Author(s):  
Da-Geng Huang ◽  
Ding-Jun Hao ◽  
Yong-Hong Jiang ◽  
Yue Cheng ◽  
Jun-Wei Pan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Atlantoaxial Instability ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Nerve Dysfunction ◽  
C1 Lateral Mass Screw

Combined C1-C2 Transarticular with C1 Lateral Mass Screw Fixation for the Treatment of Atlantoaxial Instability: A Single Center Experience

2016 ◽  
Vol 3 (4) ◽  
pp. 133-139 ◽  
Author(s):  
Murtuza Sikander ◽  
Sean Martin ◽  
Bassam Dabbous ◽  
Stewart Griffiths ◽  
Sumit Karia ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Atlantoaxial Instability ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Single Center ◽  
Single Center Experience ◽  
C1 Lateral Mass Screw

C2 Nerve Root Transection During C1 Lateral Mass Screw Fixation

Neurosurgery ◽  
2014 ◽  
Vol 74 (5) ◽  
pp. 475-481 ◽  
Author(s):  
Michael C. Dewan ◽  
Saniya S. Godil ◽  
Stephen K. Mendenhall ◽  
Clinton J. Devin ◽  
Matthew J. McGirt
Keyword(s):  
Nerve Root ◽  
Screw Fixation ◽  
Neck Disability Index ◽  
Occipital Neuralgia ◽  
Lateral Mass ◽  
Negative Consequences ◽  
Lateral Mass Screw ◽  
Patient Reported ◽  
C2 Nerve Root ◽  
C1 Lateral Mass Screw

Abstract BACKGROUND: Sectioning of the C2 nerve root allows for direct visualization of the C1-2 joint and may facilitate arthrodesis. OBJECTIVE: To determine the clinical and functional consequences of C2 nerve root sectioning during placement of C1 lateral mass screws. METHODS: All patients undergoing C1 lateral mass screw fixation were included in this prospective study. A standard questionnaire was used to determine the severity of occipital numbness/pain and its effect on quality of life (QOL). Domains of the neck disability index were used to assess the disability related to C2 symptoms. RESULTS: A total of 28 patients were included (C2 transection, 8; C2 preservation, 20). A trend of decreased blood loss and length of surgery was observed in the C2 transection cohort. Occipital numbness was reported by 4 (50.0%) patients after C2 transection. Occipital neuralgia was reported by 7 (35.0%) patients with C2 preservation. None of the patients with numbness after C2 transection reported being “bothered” by it. All patients with occipital neuralgia after C2 sparing reported being “bothered” by it, and 57.1% reported a moderate to severe effect on QOL. The use of medication was reported by 5 (71.4%) patients with neuralgia vs none with numbness. Mean disability was significantly higher with neuralgia vs numbness (P = .016). CONCLUSION: C2 nerve root transection is associated with increased occipital numbness but this has no effect on patient-reported outcomes and QOL. C2 nerve root preservation can be associated with occipital neuralgia, which has a negative impact on patient disability and QOL. C2 nerve root transection has no negative consequences during C1-2 stabilization.

Placement of C1 Lateral Mass Screw—Alternative Technique: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (3) ◽  
pp. E297-E297 ◽  
Author(s):  
R Tushar Jha ◽  
Nicholas Dietz ◽  
Ehsan Dowlati ◽  
Faheem Sandhu
Keyword(s):  
Neck Pain ◽  
Atlantoaxial Instability ◽  
Alternative Technique ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Fusion Construct ◽  
Flexion Extension ◽  
The Rich ◽  
Posterior Instrumented Fusion ◽  
C1 Lateral Mass Screw

Abstract This operative video demonstrates a C1 lateral mass instrumentation technique that is an alternative to the traditional Goel and Harms techniques.1,2 The advantages of the alternative technique include minimized blood loss from the rich venous plexus surrounding the C2 dorsal root ganglia (DRG), avoidance and preservation of the C2 DRG, and placement of a robust fully threaded screw without risking neuralgia. These are discussed in detail and presented through a case of atlantoaxial instability. Patient's consent was obtained for creating this surgical video. The patient is a 50-yr-old woman with a 17-yr history of rheumatoid arthritis. She presented with 1 yr of neck pain that failed conservative measures. Flexion-extension radiographs demonstrated an atlantodental index (ADI) that reduced from 7 mm on flexion to 0 mm on extension. The patient underwent a C1-C2 posterior instrumented fusion using the alternative technique of C1 lateral mass instrumentation.2 The steps of this technique are explained in great detail through a microsurgical video. The patient's postoperative course was uneventful. Postoperative radiographs and computed tomography (CT) scan demonstrated reduction of ADI and well-placed instrumentation and fusion construct. Her neck pain was completely resolved by 3 mo following surgical stabilization. In the senior author's experience with placing over 120 C1 lateral mass screws with this alternative technique, there have been no instances of vascular injury, sacrifice of C2 DRG, or instrumentation failure. The alternative technique for placement of C1 lateral mass screw is safe, efficient, and holds certain advantages in comparison to the traditionally described method.  Images within the video have been reproduced from AOSpine section of the AO Surgery Reference, www.aosurgery.org, with permission from AO Surgery. Copyright by AOSpine International, Switzerland; and reprinted from World Neurosurgery, 78(1-2), Kang MM et al, C2 Nerve Root Sectioning in Posterior C1-2 Instrumented Fusions, 170-177, Copyright 2012, with permission from Elsevier.

C-1 Lateral Mass Screw Fixation in Children With Atlantoaxial Instability: Case Series and Technical Report

2010 ◽  
Vol 23 (7) ◽  
pp. 474-479 ◽  
Author(s):  
Rasesh Desai ◽  
Charles B. Stevenson ◽  
Alvin H. Crawford ◽  
Abubakar Atiq Durrani ◽  
Francesco T. Mangano
Keyword(s):  
Screw Fixation ◽  
Case Series ◽  
Atlantoaxial Instability ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Technical Report

Biomechanical Comparison of Unicortical Versus Bicortical C1 Lateral Mass Screw Fixation

2007 ◽  
Vol 20 (7) ◽  
pp. 505-508 ◽  
Author(s):  
Jason C. Eck ◽  
Matt P. Walker ◽  
Bradford L. Currier ◽  
Qingshan Chen ◽  
Michael J. Yaszemski ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Biomechanical Comparison ◽  
C1 Lateral Mass Screw

197 C2 Nerve Root Transection During C1 Lateral Mass Screw Fixation

Neurosurgery ◽  
2013 ◽  
Vol 60 ◽  
pp. 185
Author(s):  
Michael C. Dewan ◽  
Saniya S. Godil ◽  
Matthew J. McGirt
Keyword(s):  
Nerve Root ◽  
Screw Fixation ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
C2 Nerve Root ◽  
C1 Lateral Mass Screw

Atlantoaxial stabilization with the use of C1–3 lateral mass screw fixation

2006 ◽  
Vol 5 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Eric M. Horn ◽  
Jonathan S. Hott ◽  
Randall W. Porter ◽  
Nicholas Theodore ◽  
Stephen M. Papadopoulos ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Intraoperative Complications ◽  
Atlantoaxial Instability ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Transarticular Screw ◽  
Transarticular Screw Fixation ◽  
Cervical Orthosis ◽  
Atlantoaxial Stabilization

✓ Atlantoaxial stabilization has evolved from simple posterior wiring to transarticular screw fixation. In some patients, however, the course of the vertebral artery (VA) through the axis varies, and therefore transarticular screw placement is not always feasible. For these patients, the authors have developed a novel method of atlantoaxial stabilization that does not require axial screws. In this paper, they describe the use of this technique in the first 10 cases. Ten consecutive patients underwent the combined C1–3 lateral mass–sublaminar axis cable fixation technique. The mean age of the patients was 62.6 years (range 23–84 years). There were six men and four women. Eight patients were treated after traumatic atlantoaxial instability developed (four had remote trauma and previous nonunion), whereas in the other two atlantoaxial instability was caused by arthritic degeneration. All had VA anatomy unsuitable to traditional transarticular screw fixation. There were no intraoperative complications in any of the patients. Postoperative computed tomography studies demonstrated excellent screw positioning in each patient. Nine patients were treated postoperatively with the aid of a rigid cervical orthosis. The remaining patient was treated using a halo fixation device. One patient died of respiratory failure 2 months after surgery. Follow-up data (mean follow-up duration 13.1 months) were available for seven of the remaining nine patients and demonstrated a stable construct with fusion in each patient. The authors present an effective alternative method in which C1–3 lateral mass screw fixation is used to treat patients with unfavorable anatomy for atlantoaxial transarticular screw fixation. In this series of 10 patients, the method was a safe and effective way to provide stabilization in these anatomically difficult patients.

A Simple Preoperative Evaluation to Avoid Postoperative C2 Nerve Dysfunction Related With C1 Lateral Mass Screw

2014 ◽  
Vol 14 (11) ◽  
pp. S44
Author(s):  
Dageng Huang ◽  
Dingjun Hao ◽  
Baorong He ◽  
Liang Yan ◽  
Yuchen Zhang
Keyword(s):  
Preoperative Evaluation ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Nerve Dysfunction ◽  
C1 Lateral Mass Screw
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