Reduction and Ring Fixation of Instable C1 Fractures with Monoaxial Pedicle Screws

Overview

Journal Arch Orthop Trauma Surg

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2017 Jun 28

PMID 28653130

Citations 8

Authors

Rainer Gumpert

Thomas Poglitsch

Renate Krassnig

Rudolf Pranzl

Paul Puchwein

Affiliations

Soon will be listed here.

Abstract

Introduction: Ring fixation of C1 can be performed using pedicle screws and a rod in case of unstable Jefferson or lateral mass fractures of C1.

Materials And Methods: In a case series of three patients, we stabilized C1 fractures surgically using a modified technique of C1 ring fixation by using monoaxial instead of polyaxial screws. Functional outcome and pain was recorded postoperatively.

Results: In this very small case series, we observed good results concerning pain and functional outcome. All fractures were bony healed within 13 weeks. In one case, a screw penetrated the spinal canal and had to be repositioned. A mild irritation of C2 nerve root occurred in two cases postoperatively.

Conclusion: C1 Ring fusion with monoaxial screws provides a good ability to reduce the fracture indirectly by the screws and the rod itself.

Citing Articles

Motion-preserving C1 lateral mass fixation with compression for unstable Jefferson fracture of the Atlas: technical note.

Beucler N, Sellier A, Dagain A Neurosurg Rev. 2024; 47(1):650.

PMID: 39302548 DOI: 10.1007/s10143-024-02898-9.

Isolated C1 arch fractures: C1-2 fusion vs. C1 osteosynthesis - surgical strategies for potentially unstable injuries.

Denton H, McDonnell J, Curran J, Wilson K, Temperley H, Cunniffe G Eur Spine J. 2024; 33(10):3904-3914.

PMID: 39212713 DOI: 10.1007/s00586-024-08460-x.

Biomechanical effects of posterior lumbar interbody fusion with vertical placement of pedicle screws compared to traditional placement.

Jiang J, Zhao C, Zhang J, Xu R, Chen L World J Clin Cases. 2024; 12(20):4108-4120.

PMID: 39015896 PMC: 11235545. DOI: 10.12998/wjcc.v12.i20.4108.

Direct osteosynthesis in the treatment of atlas burst fractures: a systematic review.

Niu H, Zhang J, Yan Y, Yang K, Zhang Y J Orthop Surg Res. 2024; 19(1):129.

PMID: 38331873 PMC: 10851607. DOI: 10.1186/s13018-024-04571-9.

Design of a novel lateral mass screw-plate system for the treatment of unstable atlas fractures: a finite element analysis.

Niu H, Zhang J, Yan Y, Zhao C, Yang K, Zhang Y J Orthop Surg Res. 2024; 19(1):120.

PMID: 38317156 PMC: 10840214. DOI: 10.1186/s13018-024-04582-6.

References

Kakarla U, Chang S, Theodore N, Sonntag V . Atlas fractures. Neurosurgery. 2010; 66(3 Suppl):60-7. DOI: 10.1227/01.NEU.0000366108.02499.8F. View

Ma W, Xu N, Hu Y, Li G, Zhao L, Sun S . Unstable atlas fracture treatment by anterior plate C1-ring osteosynthesis using a transoral approach. Eur Spine J. 2013; 22(10):2232-9. PMC: 3804683. DOI: 10.1007/s00586-013-2870-x. View

Hadley M, Dickman C, Browner C, Sonntag V . Acute traumatic atlas fractures: management and long term outcome. Neurosurgery. 1988; 23(1):31-5. DOI: 10.1227/00006123-198807000-00007. View

Harms J, Melcher R . Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine (Phila Pa 1976). 2001; 26(22):2467-71. DOI: 10.1097/00007632-200111150-00014. View

Levine A, Edwards C . Fractures of the atlas. J Bone Joint Surg Am. 1991; 73(5):680-91. View