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Revista Portuguesa de Ortopedia e Traumatologia

On-line version ISSN 1646-2939

Abstract

BRITO, Joaquim Soares do; HENRIQUES, Rita Silveira; MORENO, António Tirado  and  FERNANDES, Pedro Silva. Meniscectomia parcial e risco de gonartrose. Rev. Port. Ortop. Traum. [online]. 2016, vol.24, n.4, pp.277-288. ISSN 1646-2939.

Atlanto-axial (C1-C2) complex instability can be triggered by different clinical conditions and several techniques have been described to obtain surgical stability. We documented the clinical outcomes of posterior C1-C2 fixation with polyaxial screw-rod system. The present study reports our experience in a consecutive series of 11 patients, operated between 2009 and 2014, due to post-traumatic atlanto-axial instability. For C1-C2 stabilization we used Harms technique. Eleven patients with a mean age of 54 years (range: 4-75) were included. Minimal follow-up was 12 months. One patient had transient complaints in C2 sensitive territory. Five patients had complaints related to rotation deficit and another had mild cervical pain. In one patient we had to place a C2 laminar screw instead of the usual transpedicular due to technical difficulties. All patients with one single exception evolved to bone fusion confirmed by image criteria. No vascular, dural or persistent neurological complications were disclosed. Despite our short experience, the results obtained show good reliability, which allow us to indicate the Harms technique as a first-line choice for posterior C1-C2 surgical fixation in atlanto-axial instability.

Keywords : Atlanto-axial instability; Harms; C1-C2 poliaxial screws.

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