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Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients

Background and Objectives: Posterior C1–C2 fixation, with trans-articular screws (TAS) or screw-rod-construct (SRC), is the main surgical technique for atlantoaxial instability, and can be performed with a fluoroscopy-assisted free-handed technique or 3D navigation. This study aimed to evaluate comp...

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Autores principales: Tatter, Charles, Fletcher-Sandersjöö, Alexander, Persson, Oscar, Burström, Gustav, Edström, Erik, Elmi-Terander, Adrian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779556/
https://www.ncbi.nlm.nih.gov/pubmed/35056423
http://dx.doi.org/10.3390/medicina58010114
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author Tatter, Charles
Fletcher-Sandersjöö, Alexander
Persson, Oscar
Burström, Gustav
Edström, Erik
Elmi-Terander, Adrian
author_facet Tatter, Charles
Fletcher-Sandersjöö, Alexander
Persson, Oscar
Burström, Gustav
Edström, Erik
Elmi-Terander, Adrian
author_sort Tatter, Charles
collection PubMed
description Background and Objectives: Posterior C1–C2 fixation, with trans-articular screws (TAS) or screw-rod-construct (SRC), is the main surgical technique for atlantoaxial instability, and can be performed with a fluoroscopy-assisted free-handed technique or 3D navigation. This study aimed to evaluate complications, radiological and functional outcome in patients treated with a fluoroscopy-assisted technique. Materials and Methods: A single-center consecutive cohort study was conducted of all adult patients who underwent posterior C1–C2 fixation, using TAS or CRS, between 2005–2019. Results: Seventy-eight patients were included, with a median follow-up time of 6.8 years. Trauma was the most common injury mechanism (64%), and cervicalgia the predominant preoperative symptom (88%). TAS was used in 33%, and SRC in 67% of cases. Surgery was associated with a significant reduction in cervicalgia (from 88% to 26%, p < 0.001). The most common complications were vertebral artery injury (n = 2, 2.6%), and screw malposition (n = 5, 6.7%, of which 2 were TAS and 3 were SRC). No patients deteriorated in their functional status following surgery. Conclusions: Fluoroscopy-assisted C1–C2 fixation with TAS or SRC is a safe and effective treatment for atlantoaxial instability, with a low complication rate, few surgical revisions, and pain relief in the majority of the cases.
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spelling pubmed-87795562022-01-22 Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients Tatter, Charles Fletcher-Sandersjöö, Alexander Persson, Oscar Burström, Gustav Edström, Erik Elmi-Terander, Adrian Medicina (Kaunas) Article Background and Objectives: Posterior C1–C2 fixation, with trans-articular screws (TAS) or screw-rod-construct (SRC), is the main surgical technique for atlantoaxial instability, and can be performed with a fluoroscopy-assisted free-handed technique or 3D navigation. This study aimed to evaluate complications, radiological and functional outcome in patients treated with a fluoroscopy-assisted technique. Materials and Methods: A single-center consecutive cohort study was conducted of all adult patients who underwent posterior C1–C2 fixation, using TAS or CRS, between 2005–2019. Results: Seventy-eight patients were included, with a median follow-up time of 6.8 years. Trauma was the most common injury mechanism (64%), and cervicalgia the predominant preoperative symptom (88%). TAS was used in 33%, and SRC in 67% of cases. Surgery was associated with a significant reduction in cervicalgia (from 88% to 26%, p < 0.001). The most common complications were vertebral artery injury (n = 2, 2.6%), and screw malposition (n = 5, 6.7%, of which 2 were TAS and 3 were SRC). No patients deteriorated in their functional status following surgery. Conclusions: Fluoroscopy-assisted C1–C2 fixation with TAS or SRC is a safe and effective treatment for atlantoaxial instability, with a low complication rate, few surgical revisions, and pain relief in the majority of the cases. MDPI 2022-01-12 /pmc/articles/PMC8779556/ /pubmed/35056423 http://dx.doi.org/10.3390/medicina58010114 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tatter, Charles
Fletcher-Sandersjöö, Alexander
Persson, Oscar
Burström, Gustav
Edström, Erik
Elmi-Terander, Adrian
Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients
title Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients
title_full Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients
title_fullStr Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients
title_full_unstemmed Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients
title_short Fluoroscopy-Assisted C1–C2 Posterior Fixation for Atlantoaxial Instability: A Single-Center Case Series of 78 Patients
title_sort fluoroscopy-assisted c1–c2 posterior fixation for atlantoaxial instability: a single-center case series of 78 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779556/
https://www.ncbi.nlm.nih.gov/pubmed/35056423
http://dx.doi.org/10.3390/medicina58010114
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