Abstract
The C1–C2 joint is affected by multiple entities that may produce biomechanical instability. Optimal management for atlanto-axial instability has been searched by ways of different surgical techniques with different results, generating discussion between second effects of a particular treatment. Posterior cervical approach dissections can place the axial neck musculature and ligaments at risk of neural denervations or vascular compromise. Either of these entities may result in significant postoperative atrophy, cervical pain, and spine instability. Minimally invasive techniques for the treatment of spinal disorders allow to our patients less morbid procedures with equal or better results compared to conventional surgery. In the following chapter, we review the anatomy of the atlanto-axial joint and propose a minimally invasive trans-muscular C1–C2 fusion technique using C1 lateral-mass screws and C2 pedicular screws. We describe cases with surgical, clinical, and radiographic follow-up.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Claybrooks R, Kayanja M, Milks R, Benzel E. Atlantoaxial fusion: a biomechanical analysis of two C1-C2 fusion techniques. Spine J. 2007;7:682–8.
Diaz R, Berbeo M, Vergara M, Villalobos L. Minimally invasive posterior C1-C2 screw fixation through an anatomical corridor preserving occipital-cervical tension band. Prospective 21 months clinical and radiological study. Oral presentation, Spine Arthroplasty Society global symposium on motion preservation technology (SAS 9), London, England, May 2009.
Farey I, Nadkarni S, Smith N. Modified Gallie technique versus transarticular screw fixation in C1-C2 fusion. Clin Orthop Relat Res. 1999;359:126–35.
Fessler R, O’Toole J, Eichholz K, Perez-Cruet M. The development of minimally invasive spine surgery. Neurosurg Clin N Am. 2006;17:401–9.
Gala VC, O’Toole JE, Voyadzis JM, Fessler RG. Posterior minimally invasive approaches for the cervical spine. Orthop Clin N Am. 2007;38(3):339–49, abstract v.
Gerszten PC, Welch WC. Spine: minimally invasive techniques. Prog Neurol Surg. 2006;19:135–51.
Goel A, Laheri V. Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien). 1994;129:47–53.
Goel A, Desai KI, Muzumdar DP. Atlanto axial fixation using plate and screw method: a report of 160 cases treated patients. Neurosurgery. 2002;51:1351–7.
Harms J, Melcher R. Posterior C1-C2 fusion with poliaxial screw and rod fixation. Spine. 2001;26(22):2467–71.
Joseffer S, Post N, Cooper P, Fremong-Boadu A. Minimally invasive atlantoaxial fixation with polyaxial screw-rod construct: technical case report. Neurosurgery. 2006;58 Suppl 2:ONS-375.
Menendez J, Wright N. Techniques of posterior C1-C2 stabilization. Neurosurgery. 2007;60 Suppl 1:103–11.
Neo M, Sakamoto T, Fujibayashi S, Nakamura T. A safe screw trajectory for atlantoaxial transarticular fixation achieved using an aiming device. Spine. 2005;30(9):236–42.
O’Toole JE, Eichholz KM, Fessler RG. Minimally invasive approaches to vertebral column and spinal cord tumors. Neurosurg Clin N Am. 2006;17(4):491–506.
Powers C, Isaacs R. Minimally invasive fusion and fixation techniques. Neurosurg Clin N Am. 2006;17:477–89.
Reilly T, Sasso R, Hall P. Atlantoaxial stabilization: clinical comparison of posterior cervical wiring technique with transarticular screw fixation. J Spinal Disord Tech. 2003;16(3):248–53.
Shad A, Shariff S, Teddy P. Craniocervical fusion for rheumatoid arthritis: comparison of sublaminar wires and the lateral mass screw craniocervical fusion. Br J Neurosurg. 2002;16(5):483–6.
Shchedrenok VV, Ivanenko AV, Sebelev KI, Moguchaia OV. Minimally invasive surgery of degenerative diseases of the spine. Vestnik Khirurgii Imeni II Grekova. 2010;169(2):102–4.
Wang M, Levi A. Minimally invasive lateral mass screw fixation in the cervical spine: initial clinical experience with long-term follow-up. Neurosurgery. 2006;58:907–12.
Winder MJ, Thomas KC. Minimally invasive versus open approach for cervical laminoforaminotomy. Can J Neurol Sci. 2011;38(2):262–7.
Xiang-Yang M, Qing-Shui Y, Zeng-Hui W, Hong X, Jing-Fa L, Shi-Zhen Z. Anatomic considerations for the pedicle screw placement in the first cervical vertebra. Spine. 2005;30(13):1519–23.
Yoshida M, Neo M, Fujibayashi S, Nakamura T. Comparison of the anatomical risk for vertebral artery injury associated with the C2-pedicle screw and atlantoaxial transarticular screw. Spine. 2006;31(15):513–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Diaz, R., Berbeo, M.E. (2015). Minimally Invasive Approach to Posterior Occiput to C2. In: Watkins, III, R., Watkins, IV, R. (eds) Surgical Approaches to the Spine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2465-3_40
Download citation
DOI: https://doi.org/10.1007/978-1-4939-2465-3_40
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-2464-6
Online ISBN: 978-1-4939-2465-3
eBook Packages: MedicineMedicine (R0)