Advantages of an on-the-screwhead crosslink connector for atlantoaxial fixation using the Goel/Harms technique

Publication date: Available online 3 February 2018 Source:Journal of Clinical Neuroscience Author(s): Jun Mizutani, Atsushi Inada, Kenji Kato, Akira Kondo, Shingo Kainuma, Kazuhiko Fujita, Kiyoshi Yagi, Yasuteru Shimamura, Muneyoshi Fukuoka, Yuta Shibamoto, Ikuo Wada, Takanobu Otsuka The goal of fixation surgery for atlantoaxial instability is to achieve solid bony fusion. Achieving bony fusion as early as possible is beneficial for patients. Although placement of a transverse cross-link connector (XL) provides greater biomechanical strength, XLs have not been able to be placed when performing the Goel/Harms procedure. Recently, placing a XL on the screw head (on-the-head XL [OH-XL]) has become a viable option during the Goel/Harms procedure. However, there is little evidence demonstrating whether applying an OH-XL achieves early solid bony union. A matched-control study was conducted to investigate whether placing an OH-XLs in C1/2 fixation surgery provides earlier bone union or not. Eighteen patients who underwent atlantoaxial fusion with OH-XLs (X-group), and 17 age and sex-matched patients without OH-XLs (NX-group) were compared. Bony union was assessed using reconstructed sagittal and coronal computed tomography images. Six months after surgery, six patients in the X-group and one patient in the NX-group achieved bony union (p = .0338). One year after surgery, 14 patients in the X-group and 4 patients in the NX-group achieved bone union (p = .0010)....
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research