Manufacture of Integrated C1 Laminar Hooks and C1–C2 Transarticular Screws

  • Tianming Xu
Part of the Translational Medicine Research book series (TRAMERE)


The C1 laminar hook that is used currently is a poor match for the C1 posterior arch and is difficult to connect directly to the C1–C2 transarticular screw (TAS). Thus, according to atlantoaxial anatomical features, an integrated C1 laminar hook and C1–C2 transarticular screw were designed, which is safer and more convenient for surgery. This chapter describes the manufacture of integrated C1 laminar hooks and C1–C2 transarticular screws.


  1. 1.
    Harms J, Melcher RP. Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine. 2001;15:2467–71.CrossRefGoogle Scholar
  2. 2.
    Dickman CA, Crawford NR, Paramore CG. Biomechanical characteristics of C1–C2 cable fixations. J Neurosurg. 1996;85:316–22.CrossRefPubMedGoogle Scholar
  3. 3.
    Dickman CA, Sonnag VK. Posterior C1–C2 transarticular screw fixation for atlantoaxial arthrodesis. J Neurosurg. 1998;43:275–80.CrossRefGoogle Scholar
  4. 4.
    Grob D, Crisco JJ, Panjabi MM, et al. Biomechanical evaluation of four different posterior atlantoaxial fixation techniques. Spine. 1992;17:480–90.CrossRefPubMedGoogle Scholar
  5. 5.
    Hanson PB, Montesano PX, Sharkey NA, et al. Anatomic and biomechanical assessment of transarticular screw fixation for atlantoaxial instability. Spine. 1991;16:1141–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Montesano PX, Juach EC, Anderson PA, et al. Biomechanics of cervical spine internal fixation. Spine. 1991;16(Suppl 3):S10–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Naderi S, Crawford NR, Song GS, et al. Biomechanical comparison of C1–C2 posterior fixations. Cable, graft, and screw combinations. Spine. 1998;23:1946–55.CrossRefPubMedGoogle Scholar
  8. 8.
    Smith MD, Kotzar G, Yoo J, et al. A biomechanical analysis of atlantoaxial stabilization methods using a bovine model: C1–C2 fixation analysis. Clin Orthop. 1993;290:285–95.Google Scholar
  9. 9.
    Wilke H-J, Fischer K, Kugler A, et al. In vitro investigations of internal fixation systems of the upper cervical spine: II. Stability of posterior atlantoaxial fixation techniques. Eur Spine J. 1992;1:191–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Melcher RP, Puttlitz CM, Kleinstueck FS, et al. Biomechanical testing of posterior atlantoaxial fixation techniques. Spine. 2002;27:2435–40.CrossRefPubMedGoogle Scholar
  11. 11.
    Richter M, Schmidt R, Claes L, et al. Posterior atlantoaxial fixation: biomechanical in vitro comparison of six different techniques. Spine. 2002;27:1724–32.CrossRefPubMedGoogle Scholar
  12. 12.
    Elgafy H, Potluri T, Goel VK, et al. Biomechanical analysis comparing three C1–C2 transarticular screw salvaging fixation techniques. Spine. 2010;35:378–85.CrossRefPubMedGoogle Scholar
  13. 13.
    Sim HB, Lee JW, Park JT, et al. Biomechanical evaluations of various c1–c2 posterior fixation techniques. Spine. 2011;36:E401–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Guo X, Ni B, Xie N, Lu X, Guo Q, Lu M. Bilateral C1–C2 transarticular screw and C1 laminar hook fixation and bone graft fusion for reducible atlantoaxial dislocation: a seven-year analysis of outcome. PLoS One. 2014;9(1):e87676.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Ni B, Guo X, Xie N, Li S, Zhou F, Zhang F, et al. C1–2 transarticular screws combined with C1 laminar hooks fixation: a modified posterior atlantoaxial fixation technique and outcome in 72 patients. Eur Spine J. 2013;22(2):260–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Guo X, Ni B, Wang M, Wang J, Li S, Zhou F. Bilateral atlas laminar hook combined with transarticular screw fixation for an unstable bursting atlantal fracture. Arch Orthop Trauma Surg. 2009;129(9):1203–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Ni B, Zhou F, Xie N, Guo X, Yang L, Guo Q, et al. Transarticular screw and c1 hook fixation for os odontoideum with atlantoaxial dislocation. World Neurosurg. 2011;75(3–4):540–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Guo X, Ni B, Zhao W, et al. Biomechanical assessment of bilateral C1 laminar hook and C1–2 transarticular screws and bone graft for atlantoaxial instability. J Spinal Disord Tech. 2009;22:578–85.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. and Shanghai Jiao Tong University Press 2018

Authors and Affiliations

  • Tianming Xu
    • 1
  1. 1.Department of OrthopedicsNo. 455 Hospital of PLAShanghaiChina

Personalised recommendations