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C1 Posterior Arch Laminoplasty

  • Jin S. Yeom
Chapter

Abstract

In most cases with C1–C2 instability, the spinal cord can satisfactorily be decompressed by simple reduction of C1–C2 subluxation. However, adequate decompression may not be obtainable in a small number of cases for several reasons. If cord compression and myelopathy symptoms are severe in such cases, direct decompression by resection or laminoplasty of C1 posterior arch is required. Posterior arch resection will result in poor recipient bed for bone graft when C1–C2 fusion is to be carried out as well. Even in cases where C1–C2 fusion is not required, posterior arch resection has several disadvantages. Considering these, the author has designed and performed his own technique of midline-splitting laminoplasty of C1 using a miniplate and a bone block. Surgical prudence is required to prevent hinge fracture during hinge opening or miniplate fixation. In addition, careful subperiosteal dissection of the hinge area and protection of the vertebral artery is required to prevent its injury.

Supplementary material

Video 45.1

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370679_1_En_45_MOESM2_ESM.pptx (296.8 mb)
Data 45.2 (PPTX 303962 kb)

Bibliography

  1. 1.
    Bydona M, Macki M, Qadia M, et al. Regression of an atlantoaxial rheumatoid pannus following posterior instrumented fusion. Clin Neurol Neurosurg. 2015;137:28–33.CrossRefGoogle Scholar
  2. 2.
    Sono T, Onishi E, Matsushita M. Radiographic risk factors and surgical outcomes for retroodontoid pseudotumors. J Spinal Disord Tech. 2014;27:E193–8.CrossRefGoogle Scholar
  3. 3.
    Barbagallo GM, Certo F, Visocchi M, et al. Disappearance of degenerative, non-inflammatory, retro-odontoid pseudotumor following posterior C1–C2 fixation: case series and review of the literature. Eur Spine J. 2013;22:S879–88.CrossRefGoogle Scholar
  4. 4.
    Suetsuna F, Narita H, Ono A, et al. Regression of retroodontoid pseudotumors following C-1 laminoplasty. Report of three cases. J Neurosurg Spine. 1999;5:455–60.CrossRefGoogle Scholar
  5. 5.
    Shimizu T, Otsuki B, Fujibayashi S, et al. Spontaneous anterior arch fracture of the atlas following C1 laminectomy without fusion: a report of three cases and finite element analysis. J Orthop Sci. 2016;21:306–15.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jin S. Yeom
    • 1
  1. 1.Department of Orthopaedic SurgerySeoul National University Bundang HospitalSungnamRepublic of Korea

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