Abstract
Atlantoaxial fusion by transarticular screw fixation provides firm fixation, and good results have been reported. However, there are also problems, such as injury of the vertebral artery at the time of screw insertion. For accurate facet fusion, we developed a new hole-in-one guide for screw fixation and obtained good results with its use. In 60 adult subjects, we measured the antero-posterior and transverse axes and determined the center of the atlantoaxial surface and the insertion point of the screw in three dimensions on computed tomography scans. Based on these values, we measured the optimum screw insertion angle on sagittal and coronal planes, and the distance between the center and the posterior margin of the joint surface; our new hole-in-one guide was produced with these data. When the guide tip is determined to be located at the center posterior margin of the axial joint surface, and the guidewire insertion point is determined to be located at the center of the axial inferior facet immediately above the C2/3 joint, the guidewire is passed through the axial pedicle and the center of the atlantoaxial joint. Since April 1997, we have used this hole-in-one guide technique in eight patients with atlantoaxial instability. The screws passed the pars interarticularis and the center of the atlantoaxial joint in all patients with safety and accuracy. No complications associated with this technique occurred.
| Original language | English |
|---|---|
| Pages (from-to) | 16-21 |
| Number of pages | 6 |
| Journal | Journal of Orthopaedic Science |
| Volume | 6 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2001 |
| Externally published | Yes |
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Keywords
- Atlantoaxial instability
- Surgical technique
- Transarticular screw fixation
ASJC Scopus subject areas
- Surgery
Cite this
The original hole-in-one guide for atlantoaxial transarticular screw fixation. / Ito, Yasuo; Hasegawa, Yasuhiro; Toda, Kazukiyo; Tanaka, Masato; Nakahara, Shinnosuke.
In: Journal of Orthopaedic Science, Vol. 6, No. 1, 2001, p. 16-21.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The original hole-in-one guide for atlantoaxial transarticular screw fixation
AU - Ito, Yasuo
AU - Hasegawa, Yasuhiro
AU - Toda, Kazukiyo
AU - Tanaka, Masato
AU - Nakahara, Shinnosuke
PY - 2001
Y1 - 2001
N2 - Atlantoaxial fusion by transarticular screw fixation provides firm fixation, and good results have been reported. However, there are also problems, such as injury of the vertebral artery at the time of screw insertion. For accurate facet fusion, we developed a new hole-in-one guide for screw fixation and obtained good results with its use. In 60 adult subjects, we measured the antero-posterior and transverse axes and determined the center of the atlantoaxial surface and the insertion point of the screw in three dimensions on computed tomography scans. Based on these values, we measured the optimum screw insertion angle on sagittal and coronal planes, and the distance between the center and the posterior margin of the joint surface; our new hole-in-one guide was produced with these data. When the guide tip is determined to be located at the center posterior margin of the axial joint surface, and the guidewire insertion point is determined to be located at the center of the axial inferior facet immediately above the C2/3 joint, the guidewire is passed through the axial pedicle and the center of the atlantoaxial joint. Since April 1997, we have used this hole-in-one guide technique in eight patients with atlantoaxial instability. The screws passed the pars interarticularis and the center of the atlantoaxial joint in all patients with safety and accuracy. No complications associated with this technique occurred.
AB - Atlantoaxial fusion by transarticular screw fixation provides firm fixation, and good results have been reported. However, there are also problems, such as injury of the vertebral artery at the time of screw insertion. For accurate facet fusion, we developed a new hole-in-one guide for screw fixation and obtained good results with its use. In 60 adult subjects, we measured the antero-posterior and transverse axes and determined the center of the atlantoaxial surface and the insertion point of the screw in three dimensions on computed tomography scans. Based on these values, we measured the optimum screw insertion angle on sagittal and coronal planes, and the distance between the center and the posterior margin of the joint surface; our new hole-in-one guide was produced with these data. When the guide tip is determined to be located at the center posterior margin of the axial joint surface, and the guidewire insertion point is determined to be located at the center of the axial inferior facet immediately above the C2/3 joint, the guidewire is passed through the axial pedicle and the center of the atlantoaxial joint. Since April 1997, we have used this hole-in-one guide technique in eight patients with atlantoaxial instability. The screws passed the pars interarticularis and the center of the atlantoaxial joint in all patients with safety and accuracy. No complications associated with this technique occurred.
KW - Atlantoaxial instability
KW - Surgical technique
KW - Transarticular screw fixation
UR - http://www.scopus.com/inward/record.url?scp=0035114582&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035114582&partnerID=8YFLogxK
U2 - 10.1007/s007760170019
DO - 10.1007/s007760170019
M3 - Article
VL - 6
SP - 16
EP - 21
JO - Journal of Orthopaedic Science
JF - Journal of Orthopaedic Science
SN - 0949-2658
IS - 1
ER -