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The Results and Complications of the C1-C2 Transarticular Screw Fixation Methods  

Choi, Jun-Woong (Department of Neurosurgery, Inha University College of Medicine)
Yoon, Seung-Hwan (Department of Neurosurgery, Inha University College of Medicine)
Park, Hyung-Chun (Department of Neurosurgery, Inha University College of Medicine)
Park, Hyeon-Seon (Department of Neurosurgery, Inha University College of Medicine)
Kim, Eun-Young (Department of Neurosurgery, Inha University College of Medicine)
Ha, Yoon (Department of Neurosurgery, Inha University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.37, no.3, 2005 , pp. 201-206 More about this Journal
Abstract
Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 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. Results: 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.
Keywords
Posterior C1-C2 transarticular screw fixation; C1-C2 instability; Rheumatoid arthritis; Os odontoideum; Psoriatic arthritis;
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