Published in

American Association of Neurological Surgeons, Journal of Neurosurgery: Spine, 2(19), p. 160-166, 2013

DOI: 10.3171/2013.5.spine12859

Links

Tools

Export citation

Search in Google Scholar

A new technique for reduction of atlantoaxial subluxation using a simple tool during posterior segmental screw fixation

Distributing this paper is prohibited by the publisher
Distributing this paper is prohibited by the publisher

Full text: Unavailable

Red circle
Preprint: archiving forbidden
Red circle
Postprint: archiving forbidden
Question mark in circle
Published version: policy unknown
Data provided by SHERPA/RoMEO

Abstract

Object The authors introduce a simple technique and tool to facilitate reduction of atlantoaxial subluxation during posterior segmental screw fixation. Methods Two types of reduction tool have been designed: T-type and L-type. A T-shaped levering tool was used when a pedicle or pars screw was used for C-2, and an L-shaped tool was used when a laminar screw was used for C-2. Twenty-two patients who underwent atlantoaxial segmental screw fixation and fusion for the treatment of anteroposterior instability or subluxation, using either of these new types of reduction tool, were enrolled. Demographic, clinical, and surgical data, which had been prospectively collected in a database, were analyzed. The atlantodens interval was measured on lateral radiographs, and the space available for the spinal cord was measured on CT scans. Results The authors could attain reduction of the atlantoaxial subluxation without difficulty using either type of tool. The preoperative atlantodens interval ranged from −16.9 to 10.9 mm in a neutral position, and the postoperative interval ranged from −2.8 to 3.0 mm, with negative values due to extension-type or mixed-type instability. The mean space available for the spinal cord significantly increased, from 9.5 mm preoperatively to 15.4 mm postoperatively (p < 0.001). Conclusions This technique allowed for controlled manipulation and reduction of the atlantoaxial subluxation without difficulty.