4.3 Article

Transarticular Fixation Following Mobilization of High-Riding Vertebral Artery

Journal

OPERATIVE NEUROSURGERY
Volume 20, Issue 4, Pages E322-E325

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/ons/opaa456

Keywords

Magerl transarticular fixation; Goel lateral mass fixation; Basilar invagination; Atlantoaxial instability

Ask authors/readers for more resources

This article presents a surgical technique for transarticular screw fixation in patients with a high-riding vertebral artery, demonstrating how mobilization of the artery loop can salvage the surgical procedure and achieve satisfactory clinical outcomes.
BACKGROUND AND IMPORTANCE: The article identifies the feasibility of transarticular screw fixation after mobilizing the vertebral artery in cases where it is in a high-riding location. CLINICAL PRESENTATION: A 42-yr-old male patient had a 4-yr history of progressive quadriparesis. Investigations revealed severe basilar invagination. There was assimilation of atlas and C2-3 fusion. The vertebral artery was high-riding into the pedicle-facet of C2 vertebra on both sides. Vertebral artery loop was exposed and mobilized inferiorly on both sides after careful drilling of pedicular bone on the posterior aspect of the dome of the artery. C2 facetal bone on the anterior face of the vertebral artery dome was now available for screw insertion. The C1-2 facets and the articulation were directly in line, making transarticular screw fixation relatively straightforward. The wide bone space available permitted insertion of 2 screws in a transarticular fashion on both sides. The patient had satisfactory clinical improvement. Imaging after 22 mo showed bone fusion across the facets. CONCLUSION: Mobilization of the high-riding vertebral artery loop can help salvage the surgical procedure of lateral mass stabilization.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.3
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available