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

Cited 17 time in Web of Science Cited 17 time in Scopus
Authors
Suh, Bo-Gun; Padua, Mary Ruth A.; Riew, K. Daniel; Kim, Ho-Joong; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S.
Issue Date
2013-08
Publisher
American Association of Neurological Surgeons
Citation
Journal of Neurosurgery : Spine Vol.19 No.2, pp. 160-166
Keywords
복합학cervical spineatlantoaxial subluxationreductionatlantoaxial instability instrumented fusionsegmental screw fixation technique
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.
ISSN
1547-5654 (print)
1547-5646 (online)
Language
English
URI
http://hdl.handle.net/10371/83760
DOI
https://doi.org/10.3171/2013.5.SPINE12859

https://doi.org/10.3171/2013.5.SPINE12859
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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