Posterior Cervical Fixation Utilizing Transarticular Screws in Combination with Lateral Mass Screws : Technical Note

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Background: We report and compare two constructs that incorporate C1-C2 transarticular screw fixation with cervical lateral-mass screw fixation: the Axis lateral mass plate system and the Vertex screw/rod system (both from Medtronic Sofamor Danek, Memphis, TN). Methods and Results: Patient 1 had post-laminectomy kyphosis with abnormal movement at C1-C2 after decompression for a Chiari malformation. We used the Axis system to place C1-C2 transarticular screws with C3-7 lateral mass screws and T1 pedicle screws. This patient had excellent bone-fusion mass with no motion on flexion/extension films. Patient 2 had severe cervical spondylosis and prior posterior cervical laminectomies from C3 to C6. He had developed C1/2 instability and an anterolisthesis of C2 on C3. We used the Vertex system to place C1-C2 transarticular screws with C3 and C4 lateral-mass screws. This patient had a solid bony fusion from C1 to C4. Conclusions: In our experience, the Vertex system more easily accommodates severe degenerative cervical curvatures and combines C1-2 transarticular screws with lateral mass screws than the Axis system.
日本脊髄外科学会の論文
2004-03-31