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Vol. 33. Issue 6.
Pages 310-317 (November - December 2022)
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Vol. 33. Issue 6.
Pages 310-317 (November - December 2022)
Clinical Research
Salvage posterior atlantoaxial fixation techniques: A retrospective study
Técnicas de fijación atlantoaxial posterior de rescate: un estudio retrospectivo
Mehmet Seçera,
Corresponding author
memetsecer@yahoo.com

Corresponding author.
, Oğuz Durmuş Karakoyunb, Murat Ulutaşc, Aykut Gökbeld, Kadir Çınare, Kazım Yiğitkanlıf
a Department of Neurosurgery, Alaaddin Keykubat University School of Medicine, Alanya, Antalya, Turkey
b Department of Neurosurgery Ordu University School of Medicine, Ordu, Turkey
c Department of Neurosurgery Harran University School of Medicine, Şanlıurfa, Turkey
d Derince Training and Research Hospital Neurosurgery Clinic, Kocaeli, Turkey
e Department of Neurosurgery Sanko University School of Medicine Konukoglu Hospital, Gaziantep, Turkey
f Medicana Hospital Neurosurgery Clinic, Bursa, Turkey
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Abstract
Object

Since the atlantoaxial region have critical neurovascular anatomy and limited bone surface for fusion, the application and choice of salvage fixation techniques are highly important. To discuss alternative posterior atlantoaxial fixation surgery techniques.

Methods

We retrospectively surgical records of 22 patients that posterior atlantoaxial fixation techniques were applied.

Results

The patients included 11 males and 11 females (mean age: 65.7 years). The fracture type that caused instability is type 2 odontoid fractures (22). In six of these patients alternative stabilization techniques were applied due to anatomical variations, huge venous bleeding and iatrogenic trauma of the screw entry points during surgery.

Conclusions

Owing to anatomical variations, intraoperative challenges, and/or instrumentation failures, performing alternative surgical fixation technique is an important factor that affects the success of stabilization of the atlantoaxial region. Knowledge of salvage techniques especially during the learning curve is vitally important. Surgeons should adapt to intraoperative surgical challenges as required.

Keywords:
Alternate surgery techniques
Salvage surgery
Surgical complications
Upper cervical trauma
Resumen
Objetivo

Dado que la región atlantoaxial tiene una anatomía neurovascular crítica y una superficie ósea limitada para la fusión, la elección y la aplicación de las técnicas de fijación de rescate son muy importantes. El objetivo de este estudio es describir técnicas alternativas de cirugía de fijación atlantoaxial posterior.

Métodos

Realizamos retrospectivamente registros quirúrgicos de 22 pacientes a los que se les aplicaron técnicas de fijación atlantoaxial posterior.

Resultados

Entre los pacientes se incluyeron 11 varones y 11 mujeres (edad media: 65,7 años). El tipo de fractura que causó inestabilidad fue la fractura de odontoides tipo 2 (22). En seis de estos pacientes se aplicaron técnicas alternativas de estabilización debido a variaciones anatómicas, sangrado venoso considerable y trauma iatrogénico en los puntos de entrada del tornillo durante la cirugía.

Conclusiones

Debido a variaciones anatómicas, dificultades intraoperatorias y/o fallas de instrumentación, la realización de una técnica de fijación quirúrgica alternativa es un factor importante que afecta el éxito de la estabilización de la región atlantoaxial. Conocer las técnicas de salvamento, especialmente durante la curva de aprendizaje, es de vital importancia. Los cirujanos deben adaptarse a los desafíos quirúrgicos intraoperatorios, según sea necesario.

Palabras clave:
Técnicas de cirugía alternativa
Cirugía de salvamento
Complicaciones quirúrgicas
Traumatismo cervical superior

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