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Revista de Ciencias Médicas de Pinar del Río

On-line version ISSN 1561-3194

Abstract

HORTA-TAMAYO, Ernesto Enrique; ACOSTA-GONZALEZ, Luis César; RODRIGUEZ-SANTILLAN, Lary Benice  and  ORTEGA-RAEZ, Diana Rosa. C1-2 transarticular screw fixation combined with Gallie technique in atloaxial dislocation. Rev Ciencias Médicas [online]. 2022, vol.26, n.4  Epub July 01, 2022. ISSN 1561-3194.

ABSTRACT

Introduction:

Multiple surgical techniques exist to treat instability of the atlantoaxial complex. Transarticular C1-2 screw fixation (Magerl's technique) has shown high fusion rates, and can be combined with the initially described wiring systems to guarantee greater stability to the construct.

Case presentation:

male, 62 years old, who after a two-meter fall, was brought to the institution reporting cervical pain and inability to move the limbs. On neurological examination, he had a grade B on the American Spinal Injury Classiffication Scale. A comminuted odontoid fracture and atloaxial dislocation were diagnosed. Cervical traction was applied and vertebral alignment was achieved. Surgical treatment was planned using Magerl's technique. Given the suboptimal trajectory of the initial screw, it was combined with posterior atloaxoid fusion, using Gallie technique. External immobilization was maintained for two weeks. At hospital discharge, the patient achieved ambulation, maintaining brachial dysparesis with distal predominance. In evolutionary radiological studies, no failure of the instrumentation system was observed.

Conclusions:

In our case, the use of the Gallie technique, in view of the malposition of one of the C1-2 transarticular screws, allowed preserving the stability of the construct.

Keywords : TOOTH AVULSION; ATLANTO-AXIAL JOINT; VERTEBRAL ARTERY; DISLOCATION.

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