S-Space College of Medicine/School of Medicine (의과대학/대학원) Orthopedic Surgery (정형외과학전공) Journal Papers (저널논문_정형외과학전공)
A new technique for reduction of atlantoaxial subluxation using a simple tool during posterior segmental screw fixation Clinical article
- Suh, Bo-Gun; Padua, Mary Ruth A.; Riew, K. Daniel; Kim, Ho-Joong; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S.
- Issue Date
- Journal of Neurosurgery : Spine Vol.19 No.2, pp. 160-166
- 복합학; cervical spine; atlantoaxial subluxation; reduction; atlantoaxial instability ; instrumented fusion; segmental screw fixation ; technique
- 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.
- 1547-5654 (print)
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