Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Troublesome Occipital Neuralgia Developed by C1-C2 Harms Construct

  • Rhee, Woo-Tack (Department of Neurosurgery Gangneung Asan Hospital College of Medicine Ulsan University) ;
  • You, Seung-Hoon (Department of Neurosurgery Gangneung Asan Hospital College of Medicine Ulsan University) ;
  • Kim, Suk-Kyoung (Department of Neurosurgery Gangneung Asan Hospital College of Medicine Ulsan University) ;
  • Lee, Sang-Youl (Department of Neurosurgery Gangneung Asan Hospital College of Medicine Ulsan University)
  • Published : 2008.02.29
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Abstract

Recently, Harms and Melcher modified Goel's approach, the C1 lateral mass and C2 pedicle screw fixation, and the new technique is currently in favor among neurosurgeons. Comparing to the advantages of Harms construct, the disadvantages were not extensively investigated. We experienced a patient with severe occipital pain developed after the C1 lateral mass screw placement for the traumatic atlantoaxial instability. We reviewed literatures about Harms construct with focus on the occipital neuralgia as a postoperative complication and suggest here technical tips to avoid the troublesome pain.

Keywords

References

  1. Bilge O : An anatomic and morphometric study of C2 nerve root ganglion and its corresponding foramen. Spine 29 : 495-499, 2004 https://doi.org/10.1097/01.BRS.0000113872.18219.7B
  2. Bogduk N : An anatomical basis for the neck-tongue syndrome. J Neurol Neurosurg Psychiatry 44 : 202-208, 1981 https://doi.org/10.1136/jnnp.44.3.202
  3. Brooks AL, Jenkins EB : Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am 60 : 279-284, 1978 https://doi.org/10.2106/00004623-197860030-00001
  4. Claybrooks R, Kayanja M, Milks R, Benzel E : Atlantoaxial fusion : a biomechanical analysis of two C1-C2 fusion techniques. Spine J : 682-688, 2007
  5. Goel A, Laheri V : Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 129 : 47-53, 1994 https://doi.org/10.1007/BF01400872
  6. Grob D, Magerl F : Surgical stabilization of C1 and C2 fractures. Orthopade 16 : 46-54, 1987
  7. Gunnarsson T, Massicotte EM, Govender PV, Raja Rampersaud Y, Fehlings MG : The use of C1 lateral mass screws in complex cervical spine surgery : indications, techniques, and outcome in a prospective consecutive series of 25 cases. J Spinal Disord Tech 20 : 308-316, 2007 https://doi.org/10.1097/01.bsd.0000211291.21766.4d
  8. Harms J, Melcher RP : Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine 26 : 2467-2471, 2001 https://doi.org/10.1097/00007632-200111150-00014
  9. Kim YS, Lee JK, Kim JH, Kim SH : Post-traumatic atlantoaxial rotatory dislocation in an adult treated by open reduction and C1-C2 transpedicular screw fixation. J Korean Neurosurg Soc 41 : 248-251, 2007 https://doi.org/10.3340/jkns.2007.41.4.248
  10. Kuroki H, Rengachary SS, Goel VK, Holekamp SA, Pitkanen V, Ebraheim NA : Biomechanical comparison of two stabilization techniques of the atlantoaxial joints : transarticular screw fixation versus screw and rod fixation. Neurosurgery 56 : 151-159, 2005
  11. Lee DY, Chung CK, Jahng TA : Atlantoaxial fixation using rod and screw for bilateral high-riding vertebral artery. J Korean Neurosurg Soc 37 : 380-382, 2005
  12. Lu J, Ebraheim NA : Anatomic considerations of C2 nerve root ganglion. Spine 23 : 649-652, 1998 https://doi.org/10.1097/00007632-199803150-00001
  13. Melcher RP, Puttlitz CM, Kleinstueck FS, Lotz JC, Harms J, Bradford DS : Biomechanical testing of posterior atalntoaxial fixation techniques. Spine 27 : 2435-2440, 2002 https://doi.org/10.1097/00007632-200211150-00004