The spine journal : official journal of the North American Spine Society · 2014
Atlantoaxial anterior transarticular screw fixation: a case series and reappraisal of the technique.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Polli Filippo Maria, Miscusi Massimo, Forcato Stefano, Raco Antonino
Аннотация
BACKGROUND CONTEXT: Atlantoaxial instability is commonly treated with C1-C2 fixation performed via posterior approaches. Although anterior transarticular screw (ATS) fixation, performed with a classic retropharyngeal approach, was described more than 10 years ago, the published literature still lacks a comprehensive analysis of the procedure and a real case series.
PURPOSE: We report a series of patients treated with atlantoaxial ATS, describing the surgical procedure in detail and discussing advantages and disadvantages of the technique.
STUDY DESIGN: The study design includes case series and technical report.
METHODS: We prospectively enrolled 15 patients affected by atlantoaxial instability secondary to trauma, degenerative diseases, or inflammatory diseases. Anterior transarticular screw fixation was performed with anteroposterior open-mouth and lateral intraoperative radiographs. All patients were evaluated radiologically at follow-up to identify bone fusion.
RESULTS: Anterior transarticular screw was performed successfully in 14 patients without complications. The procedure was aborted in a case of vertebral invagination, and one case required revision surgery owing to C2 articular bone fracture. Solid C1-C2 fusion was achieved in all cases (at 10- to 21-week follow-up) except in an elderly patient affected by severe osteoporosis. No complications occurred.
CONCLUSIONS: Although the procedure is still not widely known, ATS allows the effective and safe treatment of C1-C2 instability even in patients with systemic comorbidities. It offers several advantages over posterior approaches.
PURPOSE: We report a series of patients treated with atlantoaxial ATS, describing the surgical procedure in detail and discussing advantages and disadvantages of the technique.
STUDY DESIGN: The study design includes case series and technical report.
METHODS: We prospectively enrolled 15 patients affected by atlantoaxial instability secondary to trauma, degenerative diseases, or inflammatory diseases. Anterior transarticular screw fixation was performed with anteroposterior open-mouth and lateral intraoperative radiographs. All patients were evaluated radiologically at follow-up to identify bone fusion.
RESULTS: Anterior transarticular screw was performed successfully in 14 patients without complications. The procedure was aborted in a case of vertebral invagination, and one case required revision surgery owing to C2 articular bone fracture. Solid C1-C2 fusion was achieved in all cases (at 10- to 21-week follow-up) except in an elderly patient affected by severe osteoporosis. No complications occurred.
CONCLUSIONS: Although the procedure is still not widely known, ATS allows the effective and safe treatment of C1-C2 instability even in patients with systemic comorbidities. It offers several advantages over posterior approaches.