Ways to Enhance the Alignment and Positioning of the Screws in the Atlas Lateral Mass and Axis Pedicle for Posttraumatic Odontoid Fractures | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 16 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.432500.4256 | ||
| Authors | ||
| Hassan ahmed Abaza* 1; Mohammad Abdulsalam Soliman2 | ||
| 1zagazig, egypt | ||
| 2Neurosurgery, Al-Ahrar Teaching Hospital in Zagazig, GOTHI, Egypt | ||
| Abstract | ||
| ABSTRACT Background: Posterior atlantoaxial fixation using polyaxial C1 lateral mass and C2 pedicle screws is a widely adopted technique for managing C1-C2 instability. This study aimed to evaluate multiple methods used during the surgery to improve the alignment and screws positioning, which in turn affects the safety, accuracy, and clinical outcomes of this method in post-traumatic cases. Methods: Thirty-six patients (27 males, 9 females; mean age 28.4 ± 7 years) with atlantoaxial instability were enrolled. All patients underwent posterior fixation with polyaxial C1 lateral mass and C2 pedicle screws. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) and modified Japanese Orthopedic Association (mJOA) score. Screw placement accuracy was determined using the Gertzbein and Robbins grading system. The average follow-up period was 9.9 ± 4.1 months. Results: Significant postoperative improvement was observed; VAS reduced from 5.89 to 2.2. mJOA increased from 14.9 to 16.1 (p < 0.001). Screw placement accuracy was high: 92.4% were grade A and 7.6% grade B. Solid bony fusion was achieved in all cases. No cases of vertebral artery injury, neurological deterioration, or implant failure were recorded. Conclusion: Posterior atlantoaxial fixation with C1 lateral mass and C2 pedicle screws is a safe, accurate, and effective technique for the treatment of C1-C2 instability, achieving high fusion rates with minimal complications. | ||
| Keywords | ||
| Atlantoaxial instability; C1-2 fusion; screws accuracy; polyaxial screws; and odontoid process | ||
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