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The reinforcement of a C2 laminar screw by a C2 laminar hook as an anchor of occipito-C2 fusion

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Abstract

Although a C1–C2 transarticular screw (TAS) or a C2 pedicle screw (PS) is the most rigid anchor for C2, each entails the risk of vertebral artery injury. Although a C2 laminar screw (LS) is often used as an alternative anchor in such cases, its anchoring strength may be inadequate. We introduce a technical tip, in which a C2 LS is reinforced by a C2 infralaminar hook without extending the fusion range. Six patients, for whom a unilateral TAS or C2 PS was risky or impossible, were treated with O-C2 fusion using this technique. The post-operative course of each patient was uneventful. Bone union was achieved in all patients, except one who died of indifferent disease before the confirmation of bone union by computed tomography. This method would be a safe and non-technical-demanding option when the placement of a TAS or PS is risky or impossible.

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Conflict of interest

The authors declare that they have no conflict of interest. The authors declare that the study complies with the current laws of the country in which they were performed.

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Correspondence to Masashi Neo.

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Neo, M., Yoshitomi, H., Takemoto, M. et al. The reinforcement of a C2 laminar screw by a C2 laminar hook as an anchor of occipito-C2 fusion. Eur J Orthop Surg Traumatol 24, 635–639 (2014). https://doi.org/10.1007/s00590-013-1349-0

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  • DOI: https://doi.org/10.1007/s00590-013-1349-0

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