Posterior C1 Lateral Mass and C2 Pedicle Screw Fixation with Iliac Crest Graft in Post Traumatic Atlantoaxial Instability; Clinical and Radiological Outcome

Background: Atlanto axial instability is a serious life-threatening condition whichoccurred due to disruption of the bony and/ or the ligamentous structures of the atlasand the axis vertebrae. The common causes of instability are trauma, rheumatoidarthritis and congenital anomalies. Objective: In this retrospective study, we analyzedthe postoperative clinical and radiological outcomes of twenty one patients operatedupon for atlantoaxial instability by C1 lateral mass and C2 pedicle screw fixation.Patients and Methods: Patient selection: patients with post traumatic atlantoaxialinstability with or without bony fracture. Operation: C1 lateral mass and C2 pediclescrew fixation with iliac crest bone graft fusion. Results: Clinical and radiologicaloutcome at six months follow up interval revealed full motor recovery in twelve patients(80%) out of fifteen myelopathic patients and bony fusion was achieved in twenty onepatients (100%). No vertebral artery injury or implant failure, were encountered.Conclusion: Posterior C1 lateral mass and C2 pedicle screw fixation with iliac crestbone graft fusion is an effective and safe option for stabilizing the atlantoaxial complex.It is stronger, practical, and less dependent on anatomical variations of the vertebralartery and with no incidence of it’s injury.