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Year : 2020  |  Volume : 33  |  Issue : 4  |  Page : 1399-1404

Managing atlantoaxial instability by posterior fusion using C1 lateral mass and C2 pedicle screws

1 Department of Neurosurgical, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Neurosurgical, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Mohamed A Elnagar
3 Babel Street, Tala, Menoufia 32511
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_98_20

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Objective The aim was to evaluate the posterior atlantoaxial fixation using C1 lateral mass and C2 pedicle by a polyaxial screw in atlantoaxial instability correction. Background The craniocervical junction refers to the transitional zone between the cranial base and the upper cervical spine. Owing to the complexity of this area, almost all stabilization techniques are traditionally limited. However, C1 lateral mass – C2 pedicle screw fixation is gaining popularity in handling the atlantoaxial instability. Patients and methods This study included patients with craniocervical instability admitted to the Departments of Neurosurgery at Menoufia University and Nasser Institute during the period from May 2016 to April 2018 (almost 2 years) with a follow-up period up to 6 months. Participants were treated during the study period by C1 lateral mass and C2 pedicle screws. Results A total of nine cases were included, comprising 67% males and 33% females. Quadriparesis was the common presentation in 45% of patients, followed by those with neck pain or paresthesia. The mean operative time was ∼160 min. Of nine patients, three experienced mild complications, without mortality or morbidity, such as numbness, dural tear, and wound infection. Conclusion C1 lateral mass and C2 pedicle screw procedure is safe and provides reasonably efficient results for correcting atlantoaxial instability cases, with minimal adverse effects.

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