T he treatment of combination atlas-axis fractures based primarily on the specific characteristics of the axis fracture is recommended. • External immobilization of most C1-C2 combination fractures is recommended. • C1-type II odontoid combination fractures with an atlanto-dental ratio of $ 5 mm and C1-Hangman combination fractures with C2C3 angulation of $ 11 should be considered for surgical ...

In this report we describe a patient with an unstable Jefferson fracture who was treated by occipitocervical fusion and later reported sustained postoperative occipital neuralgia. A 70-year-old male was admitted to our center with a Jefferson fracture induced by a car accident. Preoperative lateral X-ray revealed an atlanto-dens interval of 4.8mm and a C1 canal anterior-posterior diameter of 19...

Posterior atlantoaxial (C1-2) fixation with individual screw placement in C1 and C2 has been one of the technical options to treat C1-2 subluxation or instability. In the present study, we demonstrate the surgical technique of C2 nerve root resection to avoid the troublesome bleeding from the perivertebral venous plexus and achieve full exposure of the lateral C1-2 joints. The present study inc...

STANDARDS There is insufficient evidence to support treatment standards. GUIDELINES There is insufficient evidence to support treatment guidelines. OPTIONS Treatment of atlas-axis combination fractures based primarily on the specific characteristics of the axis fracture is recommended. External immobilization of most C1--C2 combination fractures is recommended. C1--Type II odontoid combinat...

STUDY DESIGN Biomechanical, cadaveric study. OBJECTIVES To compare the relative stiffness of unilateral C1 lateral mass-C2 intralaminar fixation to intact specimens and bilateral C1 lateral mass-C2 intralaminar constructs. METHODS The biomechanical integrity of a unilateral C1 lateral mass-C2 intralaminar screw construct was compared to intact specimens and bilateral C1 lateral mass-C2 intr...

AIM In this study, we aimed at sharing our experiences and contributing to the literature by making a retrospective analysis of the patients we operated with screw-rod system for atlantoaxial instability in our clinic. MATERIAL AND METHODS Archive files of adult patients, who were operated for posterior C1-C2 stabilization with screw and rod in our clinic between January 2006 and January 2016...

BACKGROUND Basilar invagination is a rare clinical condition characterized by upward protrusion of the odontoid process into the intracranial space, leading to bulbomedullary compression. It is often encountered in adults with rheumatoid arthritis. Transoral microscopic or endonasal endoscopic decompression may be pursued, with or without posterior fixation. We present a case of basilar invagin...

OBJECTIVE To investigate the feasibility of C1 lateral mass screw and C2 pedicle screw with polyaxial screw and rod system supplemented with miniplate for interlaminar fusion to treat various atlantoaxial instabilities. METHODS After posterior atlantoaxial fixation with lateral mass screw in the atlas and pedicle screw in the axis, we used 2 miniplates to fixate interlaminar iliac bone graft ...

Objective: The morbidity and mortality are high for traumatic upper cervical spine instability with cervico-medullary compression. In a clinical retrospective study, the clinical and radiographic results of occipitocervical (OC) fusion using posterior atlantoaxial transpedicular screw fixation in 12 patients with traumatic upper cervical spine instability was reviewed. Methods: Twelve patients ...

Abstract Hypertrophic dens is an inflammatory process at the C1-C2 level leading to mass formation behind dens. The cervical region, which contains vital nerve fibers, plays a crucial role in maintaining body control; hence, dysfunction this harmful. However, surgical treatment risky and may greatly impact quality of life, even with successful procedure. Consequently, recent studies focus on id...