Steinmann Pins for C1 Lateral Mass Screw Placement Throughout Atlantoaxial Stabilization.
World Neurosurg. 2017 Dec;108:560-565
Authors: Meyers JE, Vakharia Ok, Kowalski JM, Dimopoulos VG, Pollina J
OBJECTIVE: The authors describe a modified approach for placement of the C1 lateral mass screw utilizing a Steinmann pin as a information. This method minimizes dissection and gives atlantoaxial stabilization throughout arthrodesis.
METHODS: In our approach, a nonthreaded 1.6-mm spade-tip Steinmann pin is positioned into the lateral mass of C1 to function a information over which a powered drill is used for screw insertion. Perioperative knowledge had been collected for consecutive sufferers who underwent a C1-2 arthrodesis that concerned the modified approach between March 2010 and July 2016. Knowledge included blood loss, operative occasions, and C2 nerve root harm.
RESULTS: The information for 93 sufferers had been reviewed. Most (91.four%) sufferers introduced with a fracture from an acute trauma. A imply of 1.97 ranges was fused in these sufferers, with a imply blood lack of 76 mL and a imply operative time of 144 minutes. The general morbidity and mortality fee was 10.7%. The morbidity fee of seven.5% included 30-day postoperative issues of respiratory failure and dysphasia. There have been no postoperative vertebral artery accidents, failures, or cases of occipital neuralgia.
CONCLUSIONS: Using Steinmann pins to information the position of C1 lateral mass screws is protected and efficient in C1-2 arthrodesis. Limiting dissection minimizes blood loss and harm, maintains environment friendly operative time, and assists in correct placement of the screws. Moreover, with much less manipulation and retraction of the C2 nerve root, postoperative occipital neuralgia and the necessity for C2 root transection are prevented.
PMID: 28927912 [PubMed – indexed for MEDLINE]