Multiple techniques exist for the fixation of C2, including axial pedicle screws and bilateral translaminar screws. We describe a novel method of incorporating both the translaminar and pedicle screws within C2 to improve fixation to the subaxial spine in patients requiring posterior cervical instrumentation for deformity correction or instability. We report three cases of patients with cervical spinal instability, who underwent cervical spine instrumentation for stabilization and/or deformity correction. Bilateral C2 pedicle screws were inserted, followed by bilateral crossed laminar screws. The instrumentation method successfully achieved fixation in all three patients. There were no immediate postoperative complications, and hardware positioning was satisfactory. Instrumenting C2 with translaminar and pedicle screws is technically feasible, and it may improve fixation to the subaxial spine in patients with poor bone quality or severe subaxial deformity, which require a stronger instrumentation construct.
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http://dx.doi.org/10.4184/asj.2015.9.5.783 | DOI Listing |
J Neurosurg Spine
January 2025
1Department of Spine Surgery, Hospital for Special Surgery, New York.
Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy.
View Article and Find Full Text PDFEur Spine J
January 2025
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China.
Purpose: To describe a novel alternative technique for C2 fixation under the concept of atlantoaxial joint distraction and fusion with intra-articular Cages, and to report its preliminary clinical outcomes.
Methods: Eighteen patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial joint distraction and fusion with intra-articular Cages. All patients had hypoplasia of the C2 isthmus prohibiting insertion of the pedicle screw.
BMC Geriatr
January 2025
Department of Neurosurgery, Yonsei University College of Medicine, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Background: Comparative studies of posterior lumbar interbody fusion with cortical bone trajectory and pedicle screw in older patients, particularly in those aged ≥ 80 years, are rare. This study aimed to retrospectively analyze the clinical and surgical outcomes following posterior lumbar interbody fusion with pedicle screw fixation compared to cortical bone trajectory in patients aged ≥ 80 years with degenerative lumbar spine disease.
Methods: We included 68 patients aged ≥ 80 years who underwent degenerative lumbar spinal surgery at our spine center between January 2011 and December 2020.
Med Leg J
January 2025
Department of Neurosurgery, Tufts Medical Center, Tufts University School of Medicine, Boston, USA.
Spine surgery is highly litigious; misplaced screws and intraoperative neuromonitoring frequently feature in lawsuits. Intraoperative neuromonitoring aims to prevent injury but its standards are debated, and literature suggests its benefits are mixed. We surveyed its use among neurosurgeons from the Congress of Neurological Surgeons with Pearson's chi-square test applied to analyse data within R.
View Article and Find Full Text PDFJ Spine Surg
December 2024
Department of Orthopedic Surgery, Toyama Prefectural Central Hospital, Toyama City, Japan.
Background: There is no consensus on the association between final local kyphosis and residual back pain (RBP) after traumatic vertebral fracture. The aim of this study was to investigate whether there is an association between the final local kyphosis angle and RBP in patients with traumatic vertebral fractures at the thoracolumbar junction who underwent single posterior surgery with percutaneous pedicle screws and implant removal after fracture healing. A second goal was to determine the optimal cut-off value for the final local kyphosis angle with and without RBP.
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