Role of the O-arm and Computer-assisted Navigation of Safe Screw Fixation in Children with Traumatic Rotatory Atlantoaxial Subluxation.
- Author:
Walid ATTIA
1
;
Tamer ORIEF
;
Khaled ALMUSREA
;
Mohamed ALFAWAREH
;
Lahbib SOUALMI
;
Yasser ORZ
Author Information
- Publication Type:Original Article
- Keywords: Atlantoaxial joint fusion; Intraoperative computer-assisted 3D navigation; Computer-assisted three-dimensional imaging
- MeSH: Atlanto-Axial Joint; Axis, Cervical Vertebra; Child; Congenital Abnormalities; Humans; Imaging, Three-Dimensional; Retrospective Studies; Vertebral Artery
- From:Asian Spine Journal 2012;6(4):266-273
- CountryRepublic of Korea
- Language:English
- Abstract: STUDY DESIGN: A retrospective analysis of 7 patients with traumatic rotatory atlanto-axial subluxation. OVERVIEW OF LITERATURE: Cases of traumatic rotatory atlantoaxial subluxation in children are difficult to be stabilized. Surgical challenges include: narrow pedicles, medial vertebral arteries, vertebral artery anomalies, fractured pedicles or lateral masses, and fixed subluxation. The use of O-arm and computer-assisted navigation are still tested as aiding tools in such operative modalities. PURPOSE: Report of clinical series for evaluation of the safety of use of the O-arm and computed assisted-navigation in screw fixation in children with traumatic rotatory atlantoaxial subluxation. METHODS: In the present study, 7 cases of rotatory atlantoaxial traumatic subluxation were operated between December 2009 and March 2011. All patient-cases had undergone open reduction and instrumentation using atlas lateral mass and axis pedicle screws with intraoperative O-arm with computer-assisted navigation. RESULTS: All hardware was safely placed in the planned trajectories in all the 7 cases. Intraoperative O-arm and computer assisted-navigation were useful in securing neural and vascular tissues safety with tough-bony purchases of the hardware from the first and only trial of application with sufficient reduction of the subluxation. CONCLUSIONS: Successful surgery is possible with using the intraoperative O-arm and computer-assisted navigation in safe and proper placement of difficult atlas lateral mass and axis pedicle screws for rotatory atlantoaxial subluxation in children.
