Atlantoaxial Stabilization Using C1 and C2 Laminar Screw Fixation

<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>

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C2 Laminar Screw Fixation

Cervical Spine Surgery: Standard and Advanced Techniques ◽

10.1007/978-3-319-93432-7_43 ◽

2019 ◽

pp. 281-289

Author(s):

Ilyas Aleem ◽

Brad Currier

Keyword(s):

Screw Fixation ◽

Laminar Screw ◽

C2 Laminar Screw

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C2 laminar screw and C1-2 transarticular screw combined with C1 laminar hooks for atlantoaxial instability with unilateral vertebral artery injury

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-011-1277-6 ◽

2011 ◽

Vol 131 (9) ◽

pp. 1207-1210 ◽

Cited By ~ 6

Author(s):

Qunfeng Guo ◽

Jun Liu ◽

Bin Ni ◽

Xuhua Lu ◽

Fengjin Zhou

Keyword(s):

Vertebral Artery ◽

Vertebral Artery Injury ◽

Atlantoaxial Instability ◽

Transarticular Screw ◽

Artery Injury ◽

Laminar Screw ◽

Laminar Hooks ◽

C2 Laminar Screw

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Mobilization of the Vertebral Artery—Surgical Option for C2 Screw Fixation in Cases With “High Riding” Vertebral Artery

Operative Neurosurgery ◽

10.1093/ons/opz289 ◽

2019 ◽

Vol 18 (6) ◽

pp. 648-651 ◽

Cited By ~ 5

Author(s):

Atul Goel ◽

Ranjit Rangnekar ◽

Abhidha Shah ◽

Survendra Rai ◽

Ravikiran Vutha

Keyword(s):

Vertebral Artery ◽

Screw Fixation ◽

Basilar Invagination ◽

Os Odontoideum ◽

Safe Procedure ◽

Screw Insertion ◽

Atlantoaxial Fixation ◽

Atlantoaxial Stabilization ◽

C2 Vertebra

Abstract BACKGROUND Mobilization of intraosseous course of vertebral artery for safe screw insertion into pedicle of axis in cases with high riding vertebral artery is discussed. OBJECTIVE To show drilling, exposure, and mobilization of the “high-riding” vertebral artery loop during its course in relationship with superior facet/pedicle of C2 vertebra can provide safety to techniques of atlantoaxial fixation that involve insertion of screws in the pars/pedicle/facet of C2. METHODS During the period June 2016 to April 2018, 15 patients operated for atlantoaxial stabilization underwent vertebral artery exposure and mobilization using the technique discussed. The ages of the patients ranged from 6 to 48 yrs. Four patients had mobile and reducible atlantoaxial dislocation. Seven patients had basilar invagination. Four patients had os-odontoideum. Gentle and precise drilling of bone that covers the “high-riding” vertebral artery can lead to its safe and wide surgical exposure. The arterial loop can then be either completely or partially mobilized out of the vertebral artery groove such that C2 screw insertion can be conducted under direct surgical visualization of the vertebral artery. RESULTS During the average follow-up period of 14 mo, there have been no complications related to the surgical procedure, metal implant, or vertebral artery. CONCLUSION Vertebral artery exposure and mobilization is rather simple and safe procedure and is remarkably effective in providing a space for C2 screw implantation.

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Combined use of intraoperative indocyanine green and dynamic angiography in rotational vertebral artery occlusion

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2016.02.007 ◽

2016 ◽

Vol 30 ◽

pp. 152-154 ◽

Cited By ~ 3

Author(s):

Nauman S. Chaudhry ◽

Sudheer Ambekar ◽

Mohamed Samy Elhammady ◽

Jonathan P. Riley ◽

Gustavo Pradilla ◽

...

Keyword(s):

Indocyanine Green ◽

Vertebral Artery ◽

Artery Occlusion ◽

Vertebral Artery Occlusion ◽

Combined Use

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Rotational obstruction of nondominant vertebral artery and ischemia

Journal of Neurosurgery ◽

10.3171/jns.1996.85.3.0507 ◽

1996 ◽

Vol 85 (3) ◽

pp. 507-509 ◽

Cited By ~ 20

Author(s):

Tetsuya Morimoto ◽

Takanobu Kaido ◽

Yoshitomo Uchiyama ◽

Hidemori Tokunaga ◽

Toshisuke Sakaki ◽

...

Keyword(s):

Vertebral Artery ◽

Three Dimensional ◽

Artery Occlusion ◽

Left Vertebral Artery ◽

Posterior Fixation ◽

Vertebrobasilar Insufficiency ◽

Atlantoaxial Joint ◽

Head Turning ◽

Content Type ◽

The Right

✓ A 70-year-old man presented with repeated vertebrobasilar insufficiency for 3 years. Four-vessel angiography revealed complete occlusion of the nondominant left vertebral artery on head turning to the right. Three-dimensional computerized tomography angiography demonstrated atlantoaxial joint dislocation when the head was turned to the right, in accordance with simultaneous occlusion of the left vertebral artery caused by stretching of the artery at C1–2. After posterior fixation of C1–2 by a Halifax interlaminar fixation system, the patient had no further episodes. Hemodynamic function associated with nondominant vertebral artery occlusion contributed to the symptoms in this case.

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