Sushil Vasant Patkar1. 1. a Poona Hospital & Research Centre , Bharati Vidyapeeth Medical College , Pune , India.
Abstract
OBJECTIVE: To reduce the chance of vertebral artery injury in posterior C1 lateral mass and C2 pedicle/pars screw-rod fixation (Goel-Harms technique ). METHOD: 49 patients, 30 males and 19 females, 12years - 82 years, underwent posterior C1-C2 fixation from February 2007 till June2013. A new entry point for the posterior C2 screw, 3mm below the midpoint of the C1-C2 joint which is directed medially and downwards into the C2 body , probably avoids the vertebral artery. As the screw now bypasses the pedicle/ pars , the chance of injuring the vertebral artery is probably reduced. RESULTS: No case of intra-operative vertebral artery injury. CONCLUSION: The new technique of C2 screw fixation allows rigid immobilization of the C1-C2 joint without significant risk of vertebral artery injury.
OBJECTIVE: To reduce the chance of vertebral artery injury in posterior C1 lateral mass and C2 pedicle/pars screw-rod fixation (Goel-Harms technique ). METHOD: 49 patients, 30 males and 19 females, 12years - 82 years, underwent posterior C1-C2 fixation from February 2007 till June2013. A new entry point for the posterior C2 screw, 3mm below the midpoint of the C1-C2 joint which is directed medially and downwards into the C2 body , probably avoids the vertebral artery. As the screw now bypasses the pedicle/ pars , the chance of injuring the vertebral artery is probably reduced. RESULTS: No case of intra-operative vertebral artery injury. CONCLUSION: The new technique of C2 screw fixation allows rigid immobilization of the C1-C2 joint without significant risk of vertebral artery injury.
Entities:
Keywords:
Atlanto - Axial Dislocation; Atlanto - Axial Fixation; Axis pars screw; Axis pedicle screw; Vertebral artery injury