STUDY DESIGN: A case report. OBJECTIVE: To describe an interesting patient who underwent open reduction and C1-C2 transpedicular screw fixation with interspinous wiring due to high-riding vertebral artery. SUMMARY OF BACKGROUND DATA: Atlantoaxial rotatory fixation (AARF) is a rare complication found most frequently after trauma in children and young adults; the clinical diagnosis is difficult and often made late. METHODS: We report a case of post-traumatic AARF associated with a facet fracture in an adult. Reduction proved difficult to obtain by skull traction and gentle manipulation. Therefore, after open reduction under general anesthesia, we performed C1-C2 transpedicular screw fixation with posterior wiring to avoid vertebral artery injury due to high-riding transverse foramen at the C2 vertebra. RESULTS: The normal atlantoaxial relation was restored and the torticollis resolved. The patient remains neurologically intact and has radiographic documentation of fusion. CONCLUSION: Although technically demanding, C1-C2 transpedicular screw fixation combined with interspinous bone graft wiring after open reduction may be an alternative treatment option if conservative treatment fails to reduce AARF.
STUDY DESIGN: A case report. OBJECTIVE: To describe an interesting patient who underwent open reduction and C1-C2 transpedicular screw fixation with interspinous wiring due to high-riding vertebral artery. SUMMARY OF BACKGROUND DATA: Atlantoaxial rotatory fixation (AARF) is a rare complication found most frequently after trauma in children and young adults; the clinical diagnosis is difficult and often made late. METHODS: We report a case of post-traumatic AARF associated with a facet fracture in an adult. Reduction proved difficult to obtain by skull traction and gentle manipulation. Therefore, after open reduction under general anesthesia, we performed C1-C2 transpedicular screw fixation with posterior wiring to avoid vertebral artery injury due to high-riding transverse foramen at the C2 vertebra. RESULTS: The normal atlantoaxial relation was restored and the torticollis resolved. The patient remains neurologically intact and has radiographic documentation of fusion. CONCLUSION: Although technically demanding, C1-C2 transpedicular screw fixation combined with interspinous bone graft wiring after open reduction may be an alternative treatment option if conservative treatment fails to reduce AARF.
Authors: Christina Ng; Jose F Dominguez; Eric Feldstein; John K Houten; Eris Spirollari; Chirag D Gandhi; Chad D Cole; Merritt D Kinon Journal: Spinal Cord Ser Cases Date: 2021-12-03
Authors: Heiko Koller; Frank Acosta; Rosemarie Forstner; Juliane Zenner; Herbert Resch; Mark Tauber; Stefan Lederer; Alexander Auffarth; Wolfgang Hitzl Journal: Eur Spine J Date: 2009-02-18 Impact factor: 3.134