Image-guided transarticular atlanto-axial screw fixation.

BACKGROUND

The aim of this paper was to outline the use of frameless stereotaxy for the safe insertion of C1/C2 transarticular screws in the clinical setting of patients with atlanto-axial instability.

METHODS

A retrospective review was conducted of cases involving the use of image guidance for the accurate placement of transarticular C1/C2 screws. The outcome measures considered were neural injury, vascular injury, death, and screw placement on postoperative imaging.

RESULTS

We evaluated 60 patients for image-guided C1/2 transarticular screw fixation. There was a total of 109 screws inserted. There were no intraoperative complications.

CONCLUSIONS

Frameless stereotaxy can be applied safely in a clinical setting for transarticular screw fixation. Image guidance can facilitate preoperative planning and help determine an optimal trajectory that avoids the vertebral artery.