Background: The surgical treatment for retro-odontoid pseudotumor (ROP) remains controversial. Posterior C1 laminectomy without fixation occasionally leads to postoperative enlargement of ROP. Because its pathogenesis is associated with atlantoaxial instability, atlantoaxial fixation with C1 laminectomy is commonly performed. Atlantoaxial fixation usually includes transarticular fixation and screw-rod fixation. However, these methods have some issues. That is, in transarticular fixation with C1 laminectomy, the bone grafting area is challenging to obtain. In screw-rod fixation with C1 laminectomy, extensive bleeding occurs at times if the lateral atlantoaxial joint is exposed to the transplant bone grafts.
Observations: Herein, the authors report a case of ROP treated with combined C1-2 transarticular screw fixation and C1 laminoplasty with interlaminar bone transplant, which can help achieve adequate spinal cord decompression and can simultaneously secure the bone grafting area between the laminae. In addition, the volume of intraoperative blood loss decreased. Postoperative magnetic resonance imaging showed sufficient decompression of the spinal cord at the C1 level, and computed tomography performed after 6 months revealed bone union between the C1 and C2 laminae.
Lessons: Combined C1-2 transarticular screw fixation and C1 laminoplasty with interlaminar bone transplant is a useful method for ROP.
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http://dx.doi.org/10.3171/CASE2289 | DOI Listing |
World Neurosurg
January 2025
Department of Endocrinology, Yinzhou No.2 Hospital, Ningbo, Zhejiang 315040, China. Electronic address:
Objective: This study aims to evaluate the clinical outcomes of utilizing C1 posterior arch screws (PAS) combined with C2 translaminar screws as an adjunct for reinforcing upper cervical spine fixation.
Methods: A retrospective analysis was conducted on four male patients who underwent surgery involving C1 PASs and C2 translaminar screws between January 2022 and February 2024. Surgical technique involved the insertion of standard C1 lateral mass screws (LMS) and C2 pedicle screws, followed by the placement of C1 PASs and C2 translaminar screws for additional fixation.
Neurosurg Rev
January 2025
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
The combination of congenital C1 occipitalization and C2-3 non-segmentation (i.e. "sandwich fusion") results in early development of atlantoaxial dislocation (AAD).
View Article and Find Full Text PDFBMC Musculoskelet Disord
November 2024
Zigong Fourth People's Hospital, Zigong, China.
Background: This study aims to conduct a finite element analysis (FEA) to assess the bio-mechanical properties of C2 sagittal-parallel pedicle screw (PPS) in fixation for atlantoaxial instability, thereby providing a theoretical foundation for its clinical application.
Methods: A total of 5 intact C1-2 finite element models were established. Based on this, instability models were developed and two different fixation methods were applied for each model: C1 lateral mass screw (LMS) combined with C2 sagittal-parallel pedicle screw (C1LMS + C2PPS), and C1 lateral mass screw combined with C2 traditional pedicle screw (C1LMS + C2PS).
Medicine (Baltimore)
October 2024
Department of Orthopedics, Affiliated Hospital of Jining Medical University, Jining City, Shandong Province, China.
Rationale: Anterior dislocation of the sacroiliac joint combined with pelvic fractures is relatively rare in clinical practice. It is often associated with hemodynamic instability and severe injuries to other regions, resulting in a complex condition, prolonged treatment duration, and high rates of mortality and disability. However, there are few reports in the literature describing the diagnosis and treatment of anterior dislocation of the sacroiliac joint.
View Article and Find Full Text PDFCureus
June 2024
Department of Orthopedic Surgery, Kurashiki Central Hospital, Okayama, JPN.
Introduction Surgical treatments for retro-odontoid pseudotumors (ROPs) include C1 laminectomies and C1-2 and occipitocervical (OC) fusions. When a C1 laminectomy is combined with a C1-2 fusion, concerns arise regarding an increased risk of pseudarthrosis due to decreased bone grafting space. Extension of the fusion area to the OC region may be considered to ensure an adequate bone graft bed.
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