CONTEXT/ OBJECTIVE: To describe the technique and clinical results of percutaneous atlantoaxial anterior transarticular fixation combined with limited exposure posterior C1/2 arthrodesis in patients with a high-riding vertebral artery. DESIGN SETTING: Zhejiang Spine Center, China. PARTICIPANTS: Five patients with a high-riding vertebral artery and an upper cervical fracture. INTERVENTIONS: Percutaneous atlantoaxial anterior transarticular screw fixation combined with limited exposure posterior C1/2 wire fusion. OUTCOME MEASURES: Computed tomography scans were used to assess the high-riding vertebral artery and feasibility of anterior transarticular screw fixation preoperatively. A Philadelphia collar was used to immobilize the neck postoperatively. Anteroposterior (open-mouth) and lateral views were obtained at pre/postoperation and at the follow-up. RESULTS: The operation was performed successfully on all of the patients, and no intraoperative operation-related complications such as nerve injury, vertebral artery, and soft tissue complications occurred. The mean follow-up period was 33.8 months (range: 24 to 58 months). No screw breakage, loosening, pullout, or cutout was observed. Bone union was achieved in all patients at the last follow-up. CONCLUSIONS: Our small case series results suggested that percutaneous anterior transarticular screw fixation combined with mini-open posterior C1/2 wire fusion is a technically minimally invasive, safe, feasible, and useful method to treat patients with a high-riding vertebral artery.
CONTEXT/ OBJECTIVE: To describe the technique and clinical results of percutaneous atlantoaxial anterior transarticular fixation combined with limited exposure posterior C1/2 arthrodesis in patients with a high-riding vertebral artery. DESIGN SETTING: Zhejiang Spine Center, China. PARTICIPANTS: Five patients with a high-riding vertebral artery and an upper cervical fracture. INTERVENTIONS: Percutaneous atlantoaxial anterior transarticular screw fixation combined with limited exposure posterior C1/2 wire fusion. OUTCOME MEASURES: Computed tomography scans were used to assess the high-riding vertebral artery and feasibility of anterior transarticular screw fixation preoperatively. A Philadelphia collar was used to immobilize the neck postoperatively. Anteroposterior (open-mouth) and lateral views were obtained at pre/postoperation and at the follow-up. RESULTS: The operation was performed successfully on all of the patients, and no intraoperative operation-related complications such as nerve injury, vertebral artery, and soft tissue complications occurred. The mean follow-up period was 33.8 months (range: 24 to 58 months). No screw breakage, loosening, pullout, or cutout was observed. Bone union was achieved in all patients at the last follow-up. CONCLUSIONS: Our small case series results suggested that percutaneous anterior transarticular screw fixation combined with mini-open posterior C1/2 wire fusion is a technically minimally invasive, safe, feasible, and useful method to treat patients with a high-riding vertebral artery.
Authors: T Henriques; B W Cunningham; C Olerud; N Shimamoto; G A Lee; S Larsson; P A McAfee Journal: Spine (Phila Pa 1976) Date: 2000-11-15 Impact factor: 3.468
Authors: Milan K Sen; Thomas Steffen; Lorne Beckman; Anthony Tsantrizos; Rudolph Reindl; Max Aebi Journal: Eur Spine J Date: 2005-01-25 Impact factor: 3.134
Authors: Sun Wing Lau; Lun Kit Sun; Raymond Lai; Man Sze Karen Luk; Yuet Sun Ng; Nang Man Raymond Wong; Pui Yau Lau Journal: Spine (Phila Pa 1976) Date: 2010-05-15 Impact factor: 3.468