Letter: C2 Pedicle Screws Combined With C1 Laminar Hooks for Reducible Atlantoaxial Dislocation: An Ideal Salvage Technique for C1-C2 Pedicle Screws

2020 ◽  
Author(s):  
Adesh Shrivastava ◽  
Pradeep Chouksey ◽  
Sumit Raj ◽  
Surya Prakash ◽  
Amit Agrawal
Keyword(s):  
Pedicle Screws ◽  
Atlantoaxial Dislocation ◽  
Laminar Hooks

C2 Pedicle Screws Combined With C1 Laminar Hooks for Reducible Atlantoaxial Dislocation: An Ideal Salvage Technique for C1-C2 Pedicle Screws

2019 ◽  
Vol 19 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Zhao Han ◽  
Jun Yang ◽  
Qunxiang Chen ◽  
Xuhua Lu ◽  
Fei Chen ◽  
...  
Keyword(s):  
Neck Disability Index ◽  
Pedicle Screws ◽  
Operation Time ◽  
Visual Analog Scale Score ◽  
Atlantoaxial Dislocation ◽  
Small Samples ◽  
Fixation Techniques ◽  
Vas Scores ◽  
Laminar Hooks ◽  
Neck Disability

Abstract BACKGROUND A C1 laminar hook can theoretically avoid vertebral artery injury and is less technically demanding. However, only few studies with small samples analyzed the short-term outcomes of C2 pedicle screws combined with C1 laminar hooks (C2PS-C1LH) technique in the treatment of atlantoaxial dislocation. Furthermore, it is not confirmed whether similar clinical outcomes can be achieved with C1-C2 pedicle screw and rod construct (PSRC). OBJECTIVE To evaluate the outcomes of C2PS-C1LH and C1-C2 PSRC fixation techniques for treating atlantoaxial dislocation. METHODS Data of 52 patients with atlantoaxial dislocation treated by C1-C2 PSRC or C2PS-C1LH fixation were retrospectively reviewed. Outcomes evaluated by visual analog scale score for neck pain (VASSNP), Neck Disability Index (NDI), atlantodental interval (ADI), and the perioperative parameters including blood loss and operation time were analyzed and compared between 2 techniques. Patient satisfaction at final follow-up was also investigated. RESULTS There were no complications related to the surgical approach and instrumentation in either group. The mean bone fusion time was 5.06 ± 1.65 mo for the C2PS-C1LH group and 3.93 ± 0.99 mo for the C1-C2 PSRC group (P > .05). Hundred percent of fusion rates were achieved in both groups at month 12 after operation. The ADI, VAS scores, the NDI scores, and the JOA scores were greatly improved in both the groups (P < .05), but there were no significant differences between the 2 groups. CONCLUSION C2PS-C1LH fixation technique was comparable to C1-C2 PSRC in the treatment of reducible atlantoaxial dislocation. C2PS-C1LH fixation was an ideal alternative strategy to C1-C2 PSRC fixation.

Biomechanical evaluation of pedicle screws versus pedicle and laminar hooks in the thoracic spine

2006 ◽  
Vol 6 (4) ◽  
pp. 444-449 ◽  
Author(s):  
Andrew Cordista ◽  
Bryan Conrad ◽  
MaryBeth Horodyski ◽  
Sheri Walters ◽  
Glenn Rechtine
Keyword(s):  
Thoracic Spine ◽  
Pedicle Screws ◽  
Biomechanical Evaluation ◽  
Laminar Hooks

Direct Posterior Reduction and Fixation for the Treatment of Basilar Invagination With Atlantoaxial Dislocation

Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 678-687 ◽  
Author(s):  
Feng-Zeng Jian ◽  
Zan Chen ◽  
Karsten H. Wrede ◽  
Madjid Samii ◽  
Feng Ling
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Pedicle Screws ◽  
Clinical Results ◽  
Basilar Invagination ◽  
Atlantoaxial Dislocation ◽  
X Rays ◽  
Resonance Imaging ◽  
Basilar Artery Thrombosis

Abstract OBJECTIVE To report the surgical technique and clinical results for the treatment of basilar invagination (BI) with atlantoaxial dislocation (AAD) by direct posterior reduction and fixation using intraoperative distraction between the occiput and C2 pedicle screws. METHODS From May 2004 to June 2008, 29 patients who had BI with AAD were surgically treated in our department. Pre- and postoperative dynamic cervical x-rays, computed tomographic scans, and 3-dimensional reconstruction views were performed to assess the degree of dislocation. Ventral compression of the cervicomedullary junction was evaluated by magnetic resonance imaging. For all patients, reduction of the AAD was conducted by intraoperative distraction between the occiput and C2 pedicle screws using a direct posterior approach. RESULTS Follow-up ranged from 6 to 50 months in 28 patients. Clinical symptoms improved in 26 patients (92.9%) and were stable in 2 patients (7.1%) without postoperative deterioration. Radiologically, complete or more than 50% reduction was achieved in 27 of 28 patients (96.4%). In 1 patient, the reduction was less than 50% because the direction of the facets on 1 side of the C1–C2 joint was vertically oriented, instead of horizontal. Overall, good decompression and bone fusion were shown on postoperative magnetic resonance imaging, computed tomography, or x-ray scans for all patients. There was 1 death in the series because of basilar artery thrombosis 1 week after the operation. CONCLUSION The direct posterior distraction technique between occiput and C2 pedicle screws is an effective, simple, fast, and safe method for the treatment of BI with AAD. Transoral odontoidectomy and cervical traction for the treatment of BI with AAD should be reconsidered.

Comparative Experimental Study of Hook and Pedicle Fixation Systems Used at Surgical Treatment of Spine Deformities

2012 ◽  
Vol 19 (3) ◽  
pp. 20-24 ◽  
Author(s):  
A. A Kuleshov ◽  
I. N Lisyansky ◽  
M. S Vetrile ◽  
N. S Gavryushenko ◽  
L. V Fomin
Keyword(s):  
Static Load ◽  
Testing Machine ◽  
Pedicle Screws ◽  
Cyclic Loads ◽  
Pedicle Fixation ◽  
Pull Out ◽  
Spine Deformities ◽  
Laminar Hooks ◽  
Vertebral Arch ◽  
Pull Out Strength

Using human cadaver spines we compared the stiffness of pedicle screws and laminar hooks under cyclic and static pull-out loads. Transpedicular and hook fixation (sub- and supralaminar) of cadaveric thoracic spine segments was performed. Axial pull-out strength was measured using w+b (walter + bai ag) servoelectric testing machine (LFV-10-T50, Switzerland). Static pull-out tests were performed on 7 spine blocks with transpedicular and 7 blocks with hook fixation. The same blocks were tested under cyclic loads. At cyclic pull-out loading 800 N strength with 5 Hz frequency was applied. It was shown that at increasing static load hook implants could bear 1417 N at average. At higher loads the vertebral arch was destroyed. Transpedicular implants could bear 2286 N at average and at higher loads the screw migrated from the arch root. Cyclic tests showed that hooks could bear 2935 cycles at average and at prolonged loading the arch was destroyed. The hooks could bear the full; program of cyclic loads without destruction (18 000 cycles).

P157. Biomechanics of Posterior Hybrid Constructs Using Laminar Hooks and Pedicle Screws in Short-segment Thoracic Fixation

2007 ◽  
Vol 7 (5) ◽  
pp. 155S ◽  
Author(s):  
Alexander Jones ◽  
Mark Kayanja ◽  
Ryan Milks ◽  
Isador Lieberman
Keyword(s):  
Pedicle Screws ◽  
Short Segment ◽  
Laminar Hooks

Offset Laminar Hooks Decrease Bending Moments of Pedicle Screws During In Situ Contouring

Spine ◽  
1997 ◽  
Vol 22 (4) ◽  
pp. 376-381 ◽  
Author(s):  
Scott A. Yerby ◽  
John R. Ehteshami ◽  
Robert F. McLain
Keyword(s):  
Pedicle Screws ◽  
Bending Moments ◽  
Laminar Hooks

scholarly journals Bilateral C1 laminar hooks combined with C2 pedicle screws fixation for treatment of C1–C2 instability not suitable for placement of transarticular screws

2010 ◽  
Vol 19 (8) ◽  
pp. 1378-1382 ◽  
Author(s):  
Bin Ni ◽  
Zhuangchen Zhu ◽  
Fengjin Zhou ◽  
Qunfeng Guo ◽  
Jian Yang ◽  
...  
Keyword(s):  
Pedicle Screws ◽  
Laminar Hooks

Biomechanical analysis of a novel hook-screw technique for C1–2 stabilization

2012 ◽  
Vol 17 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Marco Túlio Reis ◽  
Eric W. Nottmeier ◽  
Phillip M. Reyes ◽  
Seungwon Baek ◽  
Neil R. Crawford
Keyword(s):  
Range Of Motion ◽  
Medical Devices ◽  
Spatial Relationship ◽  
Pedicle Screws ◽  
Biomechanical Analysis ◽  
Lateral Mass ◽  
Lateral Mass Screws ◽  
Laminar Hooks ◽  
Harms Technique

The Food and Drug Administration has not cleared the following medical devices for the use described in this study. The following medical devices are being discussed for an off-label use: cervical lateral mass screws. Object As an alternative for cases in which the anatomy and spatial relationship between C-2 and a vertebral artery precludes insertion of C-2 pedicle/pars or C1–2 transarticular screws, a technique that includes opposing laminar hooks (claw) at C-2 combined with C-1 lateral mass screws may be used. The biomechanical stability of this alternate technique was compared with that of a standard screw-rod technique in vitro. Methods Flexibility tests were performed in 7 specimens (occiput to C-3) in the following 6 different conditions: 1) intact; 2) after creating instability and attaching a posterior cable/graft at C1–2; 3) after removing the graft and attaching a construct comprising C-1 lateral mass screws and C-2 laminar claws; 4) after reattaching the posterior cable-graft at C1–2 (posterior hardware still in place); 5) after removing the posterior cable-graft and laminar hooks and placing C-2 pedicle screws interconnected to C-1 lateral mass screws via rod; and 6) after reattaching the posterior cable-graft at C1–2 (screw-rod construct still in place). Results All types of stabilization significantly reduced the range of motion, lax zone, and stiff zone compared with the intact condition. There was no significant biomechanical difference in terms of range of motion or lax zone between the screw-rod construct and the screw-claw-rod construct in any direction of loading. Conclusions The screw-claw-rod technique restricts motion much like the standard Harms technique, making it an acceptable alternative technique when aberrant arterial anatomy precludes the placement of C-2 pars/pedicle screws or C1–2 transarticular screws.

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