[Salvage posterior atlantoaxial fixation techniques: A retrospective study] [Técnicas de fijación atlantoaxial posterior de rescate: un estudio retrospectivo]

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. © 2021 Sociedad Española de Neurocirugía