Anterior transarticular screw fixation for atlantoaxial arthrodesis: A report of two cases

The sequelae of atlantoaxial instability (AAI) range from axial neck pain to life-threatening neurologic injury. Instrumentation and fusion of the C1-2 joint is often indicated in the setting of clinical or biomechanical instability. This is the first clinical report of anterior Smith-Robinson C1-2...

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Bibliographic Details
Published in:Journal of craniovertebral junction and spine 2013-07, Vol.4 (2), p.85-89
Main Authors: Carrier, Charles, Lebl, Darren, Sama, Andrew, Girardi, Federico
Format: Article
Language:English
Subjects:
Anterior approach
Arthrodesis
Atlanto-axial joint
atlantoaxial instability
C1-C2 fixation
Care and treatment
Case Report
Diagnosis
Health aspects
Injuries
Medical examination
Neck
Neck pain
Physiological aspects
Risk factors
Surgical techniques
transarticular screw fixation
Vertebrae
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Summary:The sequelae of atlantoaxial instability (AAI) range from axial neck pain to life-threatening neurologic injury. Instrumentation and fusion of the C1-2 joint is often indicated in the setting of clinical or biomechanical instability. This is the first clinical report of anterior Smith-Robinson C1-2 transarticular screw (TAS) fixation for AAI. The first patient presented with ischemic brain tissue secondary to post-traumatic C1-2 segment instability from a MVC 7 years prior to presentation. The second patient presented with a 3 year history of persistent right-sided neck and upper scalp pain. Both were treated with transarticular C1-2 fusion through decortication of the atlantoaxial facet joints and TAS fixation via the anterior Smith-Robinson approach. At 16 months follow-up, the first patient maintained painless range of motion of the cervical spine and denied sensorimotor deficits. The second patient reported 90% improvement in her pre-operative symptoms of neck pain and paresthesia. Anterior Smith-Robinson C1-2 TAS fixation provides a useful alternative to the posterior Goel and Magerl techniques for C1-2 stabilization and fusion.
ISSN:0974-8237
0976-9285
DOI:10.4103/0974-8237.128540