Intraoperative Vertebral Artery Angiography to Guide C1-2 Transarticular Screw Fixation in a Patient with Athetoid Cerebral Palsy.
10.3340/jkns.2012.51.3.177
- Author:
Jong Chul CHUNG
1
;
Sung Sam JUNG
;
Ki Seok PARK
;
Ho Gyun HA
Author Information
1. Department of Neurosurgery, Eulji University Hospital, Daejeon, Korea. twoboss21@naver.com
- Publication Type:Original Article
- Keywords:
Atlantoaxial instability;
Transarticular screw fixation;
Vertebral artery;
Intraoperative angiography;
Athetoid cerebral palsy
- MeSH:
Angiography;
Cerebral Palsy;
Congenital Abnormalities;
Fluoroscopy;
Humans;
Laminectomy;
Neck Pain;
Quadriplegia;
Spinal Stenosis;
Spine;
Vertebral Artery
- From:Journal of Korean Neurosurgical Society
2012;51(3):177-181
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present a case of an athetoid cerebral palsy with quadriparesis caused by kyphotic deformity of the cervical spine, severe spinal stenosis at the cervicomedullary junction, and atlantoaxial instability. The patient improved after the first surgery, which included a C1 total laminectomy and C-arm guided righ side unilateral C1-2 transarticular screw fixation. C1-2 fixation was not performed on the other side because of an aberrant and dominant vertebral artery (VA). Eight months after the first operation, the patient required revision surgery for persistent neck pain and screw malposition. We used intraoperative VA angiography with simultaneous fluoroscopy for precise image guidance during bilateral C1-2 transarticular screw fixation. Intraoperative VA angiography allowed the accurate insertion of screws, and can therefore be used to avoid VA injury during C1-2 transarticular screw fixation in comorbid patients with atlantoaxial deformities.
