Posterior atlantoaxial fixation: A cadaveric and fluoroscopic step-by-step technical guide
AffiliationDepartment of Surgery, Division of Neurosurgery, University of Arizona Medical Center
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CitationPosterior atlantoaxial fixation: A cadaveric and fluoroscopic step-by-step technical guide 2015, 6 (5):244 Surgical Neurology International
JournalSurgical Neurology International
RightsCopyright: © 2015 Sattarov K. This is an open‑access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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AbstractBackground: Atlantoaxial surgical fixation is widely employed treatment strategy for a myriad of pathologies affecting the stability of the atlantoaxial joint. The most common technique used in adults, and in certain cases in children, involves a posterior construct with C1 lateral mass screws, and C2 pars or pedicle screws. This technical note aims to provide a step‑by‑step guide to this procedure using cadaveric and fluoroscopic images. Methods: An embalmed, human, cadaveric, specimen was used for this study. The subject did not have obvious occipital‑cervical pathology. Dissections and techniques were performed to mimic actual surgical technique. Photographs were taken during each step, and the critical aspects of each step were highlighted. Fluoroscopic images from a real patient undergoing C1/C2 fixation were also utilized to further highlight the anatomic‑radiographic relationships. This study was performed without external or industry funding. Results: Photographic and radiographic pictures and drawings are presented to illustrate the pertinent anatomy and technical aspects of this technique. The nuances of each step, including complication avoidance strategies are also highlighted. Conclusions: Given the widespread utilization of this technique, described step‑by‑step guide is timely for surgeons and trainees alike.
DescriptionUA Open Access Publishing Fund
VersionFinal published version