Skip to main content

Minimally Invasive Posterior Trans-muscular C1–C2 Screw Fixation Through an Anatomical Corridor to Preserve Occipitocervical Tension Band: Surgical Anatomy and Clinical Experience

  • Chapter
  • First Online:
Book cover Pediatric Craniovertebral Junction Diseases

Abstract

The C1–C2 joint is affected by multiple entities that may produce biomechanical instability. Optimal management for atlantoaxial instability has been searched by ways of different surgical techniques with different results, generating discussion between second effects of a particular treatment. Lateral dissections can place the axial neck musculature and ligaments at risk of neural denervations or vascular compromise. Either of these entities may result in significant postoperative atrophy, pain, and instability. Minimally invasive techniques for the treatment of spinal disorders allow to our patients less morbid procedures with equal or better results compared to conventional surgery. In the following paper, we review the anatomy of the atlantoaxial joint and propose a minimally invasive trans-muscular C1–C2 fusion technique using C1 lateral-mass screws and C2 pedicular screws. We describe cases with surgical, clinical, and radiographic follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Claybrooks R, Kayanja M, Milks R, Benzel E (2007) Atlantoaxial fusion: a biomechanical analysis of two C1-C2 fusion techniques. Spine J 7:682–688. Menendez J, Wright N (2007) Techniques of posterior C1-C2 stabilization. Neurosurgery 60 (Suppl 1):103–111

    Google Scholar 

  2. Diaz R, Berbeo M, Vergara M, Villalobos L (2009) Minimally invasive posterior C1-C2 screw fixation through an anatomical corridor preserving occipital-cervical tension band. Prospective 21 months clinical and radiological study. Oral presentation, Spine Arthroplasty Society Global symposium on motion Preservation Technology (SAS 9). London

    Google Scholar 

  3. Farey I, Nadkarni S, Smith N (1999) Modified Gallie technique versus transarticular screw fixation in C1-C2 fusion. Clin Orthop Relat Res 359:126–135

    Article  PubMed  Google Scholar 

  4. Fessler R, O’Toole J, Eichholz K, Perez-Cruet M (2006) The development of minimally invasive spine surgery. Neurosurg Clin N Am 17:401–409

    Article  PubMed  Google Scholar 

  5. Gala VC, O’Toole JE, Voyadzis JM, Fessler RG (2007) Posterior minimally invasive approaches for the cervical spine. Orthop Clin N Am 38(3):339–349; abstract v

    Article  Google Scholar 

  6. Gerszten PC, Welch WC (2006) Spine: minimally invasive techniques. Prog Neurol Surg 19:135–151

    Article  PubMed  Google Scholar 

  7. Goel A, Laheri V (1994) Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 129:47–53

    Article  CAS  Google Scholar 

  8. Goel A, Desai KI, Muzumdar DP (2002) Atlanto axial fixation using plate and screw method: a report of 160 cases treated patients. Neurosurgery 51:1351–1357

    PubMed  Google Scholar 

  9. Harms J, Melcher R (2001) Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine 26(22):2467–2471

    Article  CAS  PubMed  Google Scholar 

  10. Joseffer S, Post N, Cooper P, Fremong-Boadu A (2006) Minimally invasive atlantoaxial fixation with polyaxial screw-rod construct: technical case report. Neurosurgery 58(Suppl 2):ONS-375

    Google Scholar 

  11. Menendez J, Wright N (2007) Techniques of posterior C1-C2 stabilization. Neurosurgery 60(Suppl 1):103–111

    Google Scholar 

  12. Neo M, Sakamoto T, Fujibayashi S, Nakamura T (2005) A safe screw trajectory for atlantoaxial transarticular fixation achieved using an aiming device. Spine 30(9):236–242

    Article  Google Scholar 

  13. O’Toole JE, Eichholz KM, Fessler RG (2006) Minimally invasive approaches to vertebral column and spinal cord tumors. Neurosurg Clin N Am 17(4):491–506

    Article  PubMed  Google Scholar 

  14. Powers C, Isaacs R (2006) Minimally invasive fusion and fixation techniques. Neurosurg Clin N Am 17:477–489

    Article  PubMed  Google Scholar 

  15. Reilly T, Sasso R, Hall P (2003) Atlantoaxial stabilization: clinical comparison of posterior cervical wiring technique with transarticular screw fixation. J Spinal Disord Tech 16(3):248–253

    Article  PubMed  Google Scholar 

  16. Shad A, Shariff S, Teddy P (2002) Craniocervical fusion for rheumatoid arthritis: comparison of sublaminar wires and the lateral mass screw craniocervical fusion. Br J Neurosurg 16(5):483–486

    Article  CAS  PubMed  Google Scholar 

  17. Shchedrenok VV, Ivanenko AV, Sebelev KI, Moguchaia OV (2010) Minimally invasive surgery of degenerative diseases of the spine. Vestn Khir Im I I Grek 169(2):102–104

    CAS  PubMed  Google Scholar 

  18. Wang M, Levi A (2006) Minimally invasive lateral mass screw fixation in the cervical spine: initial clinical experience with long-term follow-up. Neurosurgery 58:907–912

    Article  PubMed  Google Scholar 

  19. Winder MJ, Thomas KC (2011) Minimally invasive versus open approach for cervical laminoforaminotomy. Le Journal Canadien Des Sciences Neurologiques 38(2):262–267

    Google Scholar 

  20. Xiang-Yang M, Qing-Shui Y, Zeng-Hui W, Hong X, Jing-Fa L, Shi-Zhen Z (2005) Anatomic considerations for the pedicle screw placement in the first cervical vertebra. Spine 30(13):1519–1523

    Article  Google Scholar 

  21. Yoshida M, Neo M, Fujibayashi S, Nakamura T (2006) Comparison of the anatomical risk for vertebral artery injury associated with the C2-pedicle screw and atlantoaxial transarticular screw. Spine 31(15):513–517

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Roberto Díaz MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Díaz, R., Berbeo, M.E., Villalobos, L.M., Vergara, M.F., Osorio, E. (2014). Minimally Invasive Posterior Trans-muscular C1–C2 Screw Fixation Through an Anatomical Corridor to Preserve Occipitocervical Tension Band: Surgical Anatomy and Clinical Experience. In: Di Rocco, C., Akalan, N. (eds) Pediatric Craniovertebral Junction Diseases. Advances and Technical Standards in Neurosurgery, vol 40. Springer, Cham. https://doi.org/10.1007/978-3-319-01065-6_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-01065-6_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-01064-9

  • Online ISBN: 978-3-319-01065-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics