IJOCP | Volume 2015| Issue – April 2015| Page
Conference: Poona Orthopaedic Society Annual Conference POSAC-2015,      India [Click for Full details]  

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Abstract                                                                                                                 

Purpose:

To assess reduction in irreducible Atlanto-axial dislocation (AAD) and complications in patients who underwent segmental C1 C2 screw rod fixation for various craniovertebral pathologies during 2007-2014.

Overview of Literature:

Segmental C1 C2 fixation devised Dr. Goel et.al, which was modified by Dr. Harm.

Material and Methods:

Patients in whom C1 Lateral Mass screw (C1LMS) was planned were included. 28 cases had idiopathic AAD, three were posttraumatic, 1 nonunion odontoid fracture and 1 tumour. C2 ganglion was spared in all cases. Microscope was used to aid C1LMS. After insertion of C2 anchors, rods were inserted.

Results:

33 cases were included with average age of 44.46 (9-60years) and average follow-up of 30.09 months. In two cases of irreducible AAD, reduction was achieved by rod-reduction manoeuvre. C2 neuralgia encountered in two cases, managed conservatively. In 2 cases, screws were malpositioned, too anterior in one case and medial breach in other, without symptoms. Dural tear in one case was managed with lumbar drain. Vertebral artery injured in two cases of which one was due to anomalous vertebral artery. Intraoperative average blood loss was 700ml (300-1500ml).

Conclusion:

C1LMS fixation without sectioning C2 ganglion is possible. Individual anchorage of C1 and C2 provide a degree of manipulation that can exploit reduction in an irreducible AAD. Vertebral artery injury and C2 neuralgia is a rare possibility and occurs usually with C1LMS.

 

How to Cite this Abstract
 C2 Nerve root sparing C1-C2 segmental fixation: Our experience in 33 casesInternational Journal of Conference Proceedings. March 2015;(2015):58