Atlantoaxial fusion: Transarticular screws versus screw-rod constructs

摘要

The transarticular screw (TAS) fixation performed by Magerl and Seeman in 1986 was the first instrumented fusion of C1 and C2 and led to an impressive improvement in the therapy of atlanto-axiai instability with the advantage of an immediate stabilization of C1-2 (5). This technique results in arthrodesis in nearly 95% of patients and obviates the need for external immobilization (7, 8). Well-placed bicortical TAS provide a very good construct rigidity to resist screw pullout and translational and rotational forces (8). However, the necessity of a reduction before instrumentation and a rather high risk of vertebral artery injury in patients with a high-riding transverse foramen and a narrow C2 isthmus are disadvantages of this technique.