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Journal of Korean Neurosurgical Society 2005;37(3): 201-206.
The Results and Complications of the C1-C2 Transarticular Screw Fixation Methods.
Jun Woong Choi, Seung Hwan Yoon, Hyung Chun Park, Hyeon Seon Park, Eun Young Kim, Yoon Ha
Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea. nsysh@inha.ac.kr
To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings.
From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 pateints. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis.
Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. CONCLUSION: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.
Key Words: Posterior C1-C2 transarticular screw fixation; C1-C2 instability; Rheumatoid arthritis; Os odontoideum; Psoriatic arthritis
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