Revision of Atlantoaxial Fusion using Segmental Screw Fixation: Experience in Bilateral Posterior Arch Fracture of the Atlas Complicating Atlantoaxial Halifax Clamp Fixation: A Case Report.

Author: Jae Sung SUH ¹ ; Kyeong Hwan KIM ; Soon Woo HONG ; Jin Sup YEOM ; Kun Woo PARK ; Bong Soon CHANG ; Choon Ki LEE
Author Information

1. Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, Korea.
Publication Type:Case Report
Keywords: Atlantoaxial instability; Halifax clamp; Segmental screw fixation; Revision
MeSH: Spinal Cord Diseases
From:Journal of Korean Society of Spine Surgery 2007;14(3):187-191
CountryRepublic of Korea
Language:Korean
Abstract: A fracture of the posterior arch of the atlas is a rare complication of Halifax clamp fixation for atlantoaxial fusion. To the best of our knowledge, there is only one case reported reporting the English literature. Revision for this condition is challenging because of the difficulty in the surgical approach, internal fixation, and fusion. We report a case of bilateral fractures and nonunion of the posterior arch of the atlas and atlantoaxial nonunion after an atlantoaxial fusion procedure using Halifax clamp fixation, which resulted in persistent atlantoaxial instability and progressive myelopathy. Segmental screw fixation was performed using C1 lateral mass screws and C2 subarticular screws, along with intraarticular and extraarticular atlantoaxial inter-facet fusion.