scholarly journals C1–C2 pedicle screw fixation for adolescent with os odontoideum associated atlantoaxial dislocation and a compound reduction technique for irreducible atlantoaxial dislocation

2019 ◽  
Vol 132 (10) ◽  
pp. 1253-1256
Author(s):  
Jia Liu ◽  
Ling-Jun Zhu ◽  
En-Ze Jiang ◽  
Xiao-Gang Bao ◽  
Bo Hu ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Reduction Technique ◽  
Atlantoaxial Dislocation ◽  
Os Odontoideum ◽  
C2 Pedicle Screw ◽  
Irreducible Atlantoaxial Dislocation

scholarly journals Retropharyngeal Reduction Plate for Treatment of Irreducible Atlantoaxial Dislocation: A Cadaveric Test and Finite Element Analysis

2020 ◽  
Author(s):  
Yukun Du ◽  
Zhao Meng ◽  
Jianyi Li ◽  
Zheng Zhao ◽  
Xiangyang Wang ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Atlantoaxial Dislocation ◽  
Element Analysis ◽  
Irreducible Atlantoaxial Dislocation ◽  
Plate System ◽  
Fixation System

Abstract Background: Clinical studies have shown that irreducible atlantoaxial dislocation (IAAD) can achieve reduction, decompression, fixation and fusion by transoral, posterior, and other traditional approaches. The present study aims to introduced a newly designed reduction plate through the retropharyngeal approach and evaluate its feasibility by cadaveric test and finite element analysis.Methods: A cadaveric specimen and a 45-year-old postoperative female patient diagnosed with IAAD who underwent the traditional posterior fixation were enrolled in this scientific study. The retropharyngeal approach involved placing the reduction plate into a cadaveric specimen’s cervical spine. Spiral CT thinly scanning (0.05 mm) from the base of the occipital bone to C7 vertebrae was performed and reconstructed for three-dimensional (3D) finite element analysis using Mimics software based on the Dicom data of two different fixations. Biomechanical distribution was compared between two fixations under different stress conditions, including flexion, extension, bending and rotation, respectively.Results: There was no significant difference in maximum stress between the retropharyngeal reduction plate system and the posterior atlantoaxial pedicle screw fixation system during flexion. Under states of extension, bending and rotation, the maximum stress of the reduction plate system was significantly lower than that of the posterior atlantoaxial pedicle screw fixation system. Both of the maximum stresses between two fixations were far lower than the maximum yield strength (795-827 MPa) and ultimate strength (860-896 MPa) of the titanium alloys. There was no significantly stress concentration between retropharyngeal reduction plate system and the posterior atlantoaxial pedicle screw fixation system under different movement.Conclusions: The cadaveric test showed that it is feasible to place the reduction plate using the retropharyngeal approach. The finite element analysis indicated that the retropharyngeal reduction plate system may provide relatively reliable fixation compared with traditional posterior fixation. A new choice of designing a surgical plan for treating atlantoaxial dislocation is presented.

scholarly journals An unusual injury mechanism of atlantoaxial dislocation: illustrative case

2021 ◽  
Vol 1 (24) ◽  
Author(s):  
Yakubu Ibrahim ◽  
Yiwei Zhao ◽  
Wubo Liu ◽  
Suomao Yuan ◽  
Yonghao Tian ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Atlantoaxial Dislocation ◽  
Injury Mechanism ◽  
Illustrative Case ◽  
Lateral Mass ◽  
Online Classes ◽  
C2 Pedicle Screw

BACKGROUND Atlantoaxial dislocation (AAD) is a rare and potentially life-threatening condition. Various underlying mechanisms of injury are described in the literature. Here, the authors report an unusual nontraumatic injury mechanism of AAD in a 12-year-old patient. OBSERVATIONS A 12-year-old boy presented with intolerable neck pain and numbness in both upper limbs. The patient’s symptoms had started 2 months after the initiation of online classes during the coronavirus disease 2019 pandemic without a history of trauma. He used a computer for personal study and online classes for prolonged hours with no respite. On physical and radiological evaluation, he was diagnosed with AAD. Before surgery, skull traction was applied to reduce the dislocation and posterior C1 lateral mass screw and C2 pedicle screw fixation was performed. An optimal clinical outcome was achieved with no postoperative complications. A preoperative visual analog scale score of 8.0 was reduced to 0 postoperatively. LESSONS A prolonged fixed neck posture is an unusual underlying cause of AAD. Posterior C1 lateral mass and C2 pedicle screw fixation results in an optimal clinical outcome.

C1-C2 Pedicle Screw Fixation for Pediatric Atlantoaxial Dislocation

2020 ◽  
Vol 40 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Zhi-Da Chen ◽  
Jin Wu ◽  
Cheng-Wu Lu ◽  
Wen-Rong Zeng ◽  
Zhuan-Zhi Huang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Atlantoaxial Dislocation ◽  
C2 Pedicle Screw

C1-C2 Pedicle Screw Fixation for Atlantoaxial Dislocation in Pediatric Patients Younger than 5 Years: A Case Series of 15 Patients

2017 ◽  
Vol 108 ◽  
pp. 498-505 ◽  
Author(s):  
Yue-Hui Zhang ◽  
Jiang Shao ◽  
Dean Chou ◽  
Jian-Feng Wu ◽  
Jia Song ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Pediatric Patients ◽  
Screw Fixation ◽  
Case Series ◽  
Pedicle Screw Fixation ◽  
Atlantoaxial Dislocation ◽  
C2 Pedicle Screw

Cable-Strengthened C2 Pedicle Screw Fixation in the Treatment of Congenital C2-3 Fusion, Atlas Occipitalization, and Atlantoaxial Dislocation

Neurosurgery ◽  
2012 ◽  
Vol 71 (5) ◽  
pp. 976-984 ◽  
Author(s):  
Shenglin Wang ◽  
Chao Wang ◽  
Huijie Leng ◽  
Weidong Zhao ◽  
Ming Yan ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screws ◽  
Pedicle Screw Fixation ◽  
Atlantoaxial Dislocation ◽  
C2 Pedicle Screw ◽  
Significant Difference ◽  
Solid Fusion ◽  
C2 Fixation

Abstract BACKGROUND: Atlas occipitalization and congenital C2-3 fusion often result in atlantoaxial dislocation (AAD) and superior odontoid migration that requires occipitocervical fixation. The widely used technique is posterior occiput-C2 fixation with pedicle screws. However, congenital C2-3 fusion cases tend to have thinner C2 pedicles that are inadequate for normal-sized pedicle screw fixation. With the presence of AAD, the strength of the fixation is further compromised as the C2 pedicle screws (C2PS) sustain considerable cephalic shearing force during the reduction procedure. Therefore, a novel technique has been developed to augment the C2 pedicle screw fixation with a strengthening cable. OBJECTIVE: To introduce and assess this new technique. METHODS: Seventy-six patients who underwent this procedure were reviewed. The position of the instrument and resultant fusion were examined retrospectively. In the biomechanical test, 6 fresh specimens were subjected to 2 types of fixation in the order of Oc-C2 screw-plate fixation followed by additional use of strengthening cable. Under 3 loading modes (extension-flexion, lateral bending, and axial rotation), the relative movement between the occiput and C2 was measured and compared in the form of range of motion. RESULTS: The average follow-up time was 26 months. Solid fusion was achieved in 75 patients (98.7%) as assessed radiologically. The only patient who experienced hardware failure eventually obtained solid fusion between the occiput and C2 after revision. Biomechanically, there was significant difference between the occiput and C2 fixation and cable-strengthened fixation in range of motion for all modes. CONCLUSION: This technique is a promising option for the treatment of AAD with congenital C2-3 fusion and occipitalization. Biomechanically, this technique can reduce the occipital-axial motion significantly compared with occiput-C2 fixation.

Letter to the Editor Regarding “Direct C2 Pedicle Screw Fixation for Axis Body Fracture”

2018 ◽  
Vol 111 ◽  
pp. 419
Author(s):  
Yinshun Zhang ◽  
Yun Cao ◽  
Cailiang Shen
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
C2 Pedicle Screw ◽  
Letter To The Editor ◽  
Body Fracture ◽  
Axis Body

Clinical outcome of posterior C1–C2 pedicle screw fixation and fusion for atlantoaxial instability: A retrospective study of 86 patients

2016 ◽  
Vol 32 ◽  
pp. 47-50 ◽  
Author(s):  
Yonghong Zheng ◽  
Dingjun Hao ◽  
Biao Wang ◽  
Baorong He ◽  
Huimin Hu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Atlantoaxial Instability ◽  
C2 Pedicle Screw

C1–C2 Pedicle Screw Fixation with Rigid Cantilever Beam Construct: Case Report and Technical Note

Neurosurgery ◽  
2002 ◽  
Vol 50 (2) ◽  
pp. 426-428 ◽  
Author(s):  
Daniel K. Resnick ◽  
Edward C. Benzel
Keyword(s):  
Pedicle Screw ◽  
Cantilever Beam ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Technical Note ◽  
Rigid Fixation ◽  
Transarticular Screw ◽  
Transarticular Screw Fixation ◽  
C2 Pedicle Screw ◽  
Spectrum Of Patients

ABSTRACT OBJECTIVE AND IMPORTANCE Transarticular screw fixation of the C1–C2 complex provides immediate rigid fixation of the unstable spine. The technique is not feasible in a certain proportion of patients because of the position of the vertebral artery or the patient's body habitus. CLINICAL PRESENTATION The authors describe a rigid screw technique for the surgical treatment of a woman who was excluded as a candidate for C1–C2 transarticular screw fixation. TECHNIQUE C1–C2 pedicle screw fixation was achieved using a fixed moment arm cantilever beam system. This system provided immediate rigid fixation of the C1–C2 complex in a patient who was not a candidate for transarticular screw fixation. CONCLUSION This technique is technically more forgiving than posterior transarticular screw fixation and may be applied to a broader spectrum of patients.

scholarly journals Unilateral C1 Lateral Mass and C2 Pedicle Screw Fixation for Atlantoaxial Instability in Rheumatoid Arthritis Patients: Comparison with the Bilateral Method

2015 ◽  
Vol 57 (6) ◽  
pp. 460 ◽  
Author(s):  
Seung-Chull Paik ◽  
Hyoung-Joon Chun ◽  
Koang Hum Bak ◽  
Jeil Ryu ◽  
Kyu-Sun Choi
Keyword(s):  
Rheumatoid Arthritis ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Atlantoaxial Instability ◽  
Lateral Mass ◽  
C2 Pedicle Screw
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