Abstract

FERRAZ, Diogo et al. Fixação posterior C1-2 com parafusos translaminares para os odontoideum com instabilidade atlanto-axial. Rev. Port. Ortop. Traum. [online]. 2012, vol.20, n.4, pp.445-451. ISSN 1646-2122.

Objective: describe a surgical technique of C1-C2 arthrodesis in a patient with dystopic os odontoideum and atlantoaxial instability. Methods: a 63 - year - old woman without history of known trauma. Insidious onset of bilateral radiculopathy radiated to the upper limbs associated with posterior cervical pain. Conventional radiology demonstrated os odontoideum with atlanto-axial instability. MRI confirmed the diagnosis and showed the level of myelomalacia. The preoperative CT scan is mandatory to confirm the possibility of fixing screws. Arthrodesis was performed C1-C2 level with poly - axial screws. C1 screws were directed to lateral masses. For fixation of C2 the screws were place within the crossing laminas. Both structures were stabilized by two longitudinal bars. Results: the follow up period was 20 months. During surgery a correct implementation technique occurred without neuro - vascular complications. No hardware failure or instability was noted during the follow up period. The patient reported improvement of pain complaints in the immediate postoperative period andresolution of neurological symptoms at 3 months. Conclusions: atlantoaxial fixation with bilateral, crossing C-2 translaminar screws is a low-risk surgical option in patients with instability at this level and presents bone fusion rates of 97%.

Keywords : Atlantoaxial fixation; translaminar screw; os odontoideum.

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