Asian Spine J.  2012 Dec;6(4):266-273.

Role of the O-arm and Computer-assisted Navigation of Safe Screw Fixation in Children with Traumatic Rotatory Atlantoaxial Subluxation

Affiliations
  • 1Department of Spine Surgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia. attwali@hotmail.com

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.

Keyword

Atlantoaxial joint fusion; Intraoperative computer-assisted 3D navigation; Computer-assisted three-dimensional imaging
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