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Posterior atlantoaxial fixation: A cadaveric and fluoroscopic step-by-step technical guide

UA Open Access Publishing Fund / Background: Atlantoaxial surgical fixation is widely employed treatment strategy
for a myriad of pathologies affecting the stability of the atlantoaxial joint. The most
common technique used in adults, and in certain cases in children, involves a
posterior construct with C1 lateral mass screws, and C2 pars or pedicle screws.
This technical note aims to provide a step‑by‑step guide to this procedure using
cadaveric and fluoroscopic images.
Methods: An embalmed, human, cadaveric, specimen was used for this study.
The subject did not have obvious occipital‑cervical pathology. Dissections and
techniques were performed to mimic actual surgical technique. Photographs were
taken during each step, and the critical aspects of each step were highlighted.
Fluoroscopic images from a real patient undergoing C1/C2 fixation were also
utilized to further highlight the anatomic‑radiographic relationships. This study was
performed without external or industry funding.
Results: Photographic and radiographic pictures and drawings are presented
to illustrate the pertinent anatomy and technical aspects of this technique. The
nuances of each step, including complication avoidance strategies are also
highlighted.
Conclusions: Given the widespread utilization of this technique, described
step‑by‑step guide is timely for surgeons and trainees alike.

Identiferoai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/621332
Date January 2015
CreatorsBaaj, AliA, Sattarov, Kamran, Skoch, Jesse, Abbasifard, Salman, Patel, AparS, Avila, MauricioJ, Walter, ChristinaM
ContributorsDepartment of Surgery, Division of Neurosurgery, University of Arizona Medical Center
PublisherMedKnow
Source SetsUniversity of Arizona
LanguageEnglish
Detected LanguageEnglish
TypeArticle
RightsCopyright: © 2015 Sattarov K. This is an open‑access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Relationhttp://www.surgicalneurologyint.com/text.asp?2015/6/5/244/156611

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