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  • Posterior cervical fixation with a nitinol shape memory loop for primary surgical stabilization of atlantoaxial instability – A preliminary report

    Final Number:

    Jong-Pil Eun MD., PhD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: We used a nitinol loop as a C1-2 posterior column supporter. The shape memory loop has been used previously in the thoracic and lumbar regions. The aim of this study was to evaluate a posterior fixation technique using a nitinol shape memory loop as a new method that avoids the risk of vertebral artery or nerve injury.

    Methods: We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients’ neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications.

    Results: Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period.

    Conclusions: Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

    Patient Care: Using this technique of C1-2 posterior fixation with nitinol shape memory loop,we can avoid technical demand and morbidity such as neural tissue injury,vertebral artery injury.

    Learning Objectives: To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury.

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