Abstract
Background
Transarticular C1–C2 screw fixation, first described by Magerl, is a widely accepted used technique for C1–C2 instability with a good biomechanical stability and fusion rate.
Method
We present a 69-year-old woman, who was diagnosed with a C2 Odontoid fracture type III and primarily treated with conservative treatment and collar. During first 2 weeks of follow-up, the patient developed cervical pain associated with C1–C2 instability. A minimally invasive posterior C1–C2 transarticular screw instrumentation with a percutaneus approach was performed.
Results and conclusion
Minimally invasive approach with tubular transmuscular approach for C1–C2 transarticular screws instrumentation is safe and effective for C1–C2 instability.
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References
ElSaghir H, Boehm H, Greiner-Perth R (2005) Mini-open approach combined with percutaneous transarticular screw fixation for C1-C2 fusion. Neurosurg Rev 28:59–63. https://doi.org/10.1007/s10143-004-0358-1
Goel A, Gupta S (1999) Vertebral artery injury with transarticular screws. J Neurosurg 90:376–377. https://doi.org/10.3171/jns.1999.90.2.0376a
Lvov I, Grin A, Kordonskiy A, Sytnik A, Smirnov V, Khushnazarov U, Krylov V (2019) Minimally invasive posterior transarticular stand-alone screw instrumentation of C1-C2 using a transmuscular approach: description of technique, results and comparison with posterior midline exposure. World Neurosurg 128:e796–e805. https://doi.org/10.1016/j.wneu.2019.04.259
Mandel IM, Kambach BJ, Petersilge CA, Johnstone B, Yoo JU (2000) Morphologic considerations of C2 isthmus dimensions for the placement of transarticular screws. Spine (Phila Pa 1976) 25:1542–1547. https://doi.org/10.1097/00007632-200006150-00014
Moon BJ, Choi KH, Shin DA, Yi S, Kim KN, Yoon DH, Ha Y (2018) Anatomical variations of vertebral artery and C2 isthmus in atlanto-axial fusion: consecutive surgical 100 cases. J Clin Neurosci 53:147–152. https://doi.org/10.1016/j.jocn.2018.04.058
Neo M, Fujibayashi S, Miyata M, Takemoto M, Nakamura T (2008) Vertebral artery injury during cervical spine surgery: a survey of more than 5600 operations. Spine (Phila Pa 1976) 33:779–785. https://doi.org/10.1097/BRS.0b013e31816957a7
Paramore CG, Dickman CA, Sonntag VK (1996) The anatomical suitability of the C1-2 complex for transarticular screw fixation. J Neurosurg 85:221–224. https://doi.org/10.3171/jns.1996.85.2.0221
Yamazaki M, Okawa A, Furuya T, Sakuma T, Takahashi H, Kato K, Fujiyoshi T, Mannoji C, Takahashi K, Koda M (2012) Anomalous vertebral arteries in the extra- and intraosseous regions of the craniovertebral junction visualized by 3-dimensional computed tomographic angiography: analysis of 100 consecutive surgical cases and review of the literature. Spine (Phila Pa 1976) 37:E1389–E1397. https://doi.org/10.1097/BRS.0b013e31826a0c9f
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 (Phila Pa 1976) 31:E513–E517. https://doi.org/10.1097/01.brs.0000224516.29747.52
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Dimitriou, J., Garvayo, M. & Coll, J.B. Minimally invasive posterior percutaneous transarticular C1–C2 screws: how I do it. Acta Neurochir 162, 2047–2050 (2020). https://doi.org/10.1007/s00701-020-04478-4
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DOI: https://doi.org/10.1007/s00701-020-04478-4