Lag screws for reduction of bilateral lateral mass fractures due to spinal trauma
Introduction: Bilateral fracture of the C1 lateral mass is a relatively uncommon type of traumatic lesion. Treatment of this kind of fractures is usually conservative, with either external immobilization or traction. Research question: Whether surgical management, with placement of lag screws in lat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Brain and Spine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529422000182 |
| _version_ | 1797977724225060864 |
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| author | Massimimiliano Minardi Alessandro Narducci Giovanni Giulio Vercelli Christian Francesco Carlino Federico Griva Pier Federico Pretti |
| author_facet | Massimimiliano Minardi Alessandro Narducci Giovanni Giulio Vercelli Christian Francesco Carlino Federico Griva Pier Federico Pretti |
| author_sort | Massimimiliano Minardi |
| collection | DOAJ |
| description | Introduction: Bilateral fracture of the C1 lateral mass is a relatively uncommon type of traumatic lesion. Treatment of this kind of fractures is usually conservative, with either external immobilization or traction. Research question: Whether surgical management, with placement of lag screws in lateral mass of C1, could represent a first-line treatment. Material and methods: We describe a case of 67-years old man with bilateral fractures of lateral mass of Atlas due to road accident trauma without ligament lesion but severe gap between bone edges. We performed Computed Tomography and Magnetic Resonance scans for pre-operative imaging, X-Ray and CT scan for follow-up. Medtronic navigation system was used as intraoperative guidance for screw placement. Results: Radiological and clinical results were good, with optimal bone reduction and patient's early return to daily activities. Discussion and conclusion: Surgical management remains debateable for isolated C1 lateral mass fractures. Different surgical approaches have been described for atlas fractures, such as transoral anterior C1-ring plate osteosynthesis, posterior osteosynthesis with a lateral mass screw rod, and posterior C1 to C2 fusion and C0 to C2 fusion. Minimally invasive operative treatment with lag screw and reduction of fracture's edges without occiput-C1 or C1-C2 stabilization could be the optimal treatment with good result and decreasing rate of pseudoarthrosis, allowing to avoid Halo-vest discomfort and complications. |
| first_indexed | 2024-04-11T05:11:32Z |
| format | Article |
| id | doaj.art-179e165861184586a244986fcf20b075 |
| institution | Directory Open Access Journal |
| issn | 2772-5294 |
| language | English |
| last_indexed | 2024-04-11T05:11:32Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj.art-179e165861184586a244986fcf20b0752022-12-25T04:20:05ZengElsevierBrain and Spine2772-52942022-01-012100877Lag screws for reduction of bilateral lateral mass fractures due to spinal traumaMassimimiliano Minardi0Alessandro Narducci1Giovanni Giulio Vercelli2Christian Francesco Carlino3Federico Griva4Pier Federico Pretti5Neurosurgery Unit, Department of Neuroscience, Città della salute e della Scienza Torino, Via Cherasco 15, Turin, Italy; Corresponding author.Department of Neurosurgery San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, Turin, ItalyDepartment of Neurosurgery San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, Turin, ItalyDepartment of Neurosurgery San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, Turin, ItalyDepartment of Neurosurgery San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, Turin, ItalyDepartment of Neurosurgery San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, Turin, ItalyIntroduction: Bilateral fracture of the C1 lateral mass is a relatively uncommon type of traumatic lesion. Treatment of this kind of fractures is usually conservative, with either external immobilization or traction. Research question: Whether surgical management, with placement of lag screws in lateral mass of C1, could represent a first-line treatment. Material and methods: We describe a case of 67-years old man with bilateral fractures of lateral mass of Atlas due to road accident trauma without ligament lesion but severe gap between bone edges. We performed Computed Tomography and Magnetic Resonance scans for pre-operative imaging, X-Ray and CT scan for follow-up. Medtronic navigation system was used as intraoperative guidance for screw placement. Results: Radiological and clinical results were good, with optimal bone reduction and patient's early return to daily activities. Discussion and conclusion: Surgical management remains debateable for isolated C1 lateral mass fractures. Different surgical approaches have been described for atlas fractures, such as transoral anterior C1-ring plate osteosynthesis, posterior osteosynthesis with a lateral mass screw rod, and posterior C1 to C2 fusion and C0 to C2 fusion. Minimally invasive operative treatment with lag screw and reduction of fracture's edges without occiput-C1 or C1-C2 stabilization could be the optimal treatment with good result and decreasing rate of pseudoarthrosis, allowing to avoid Halo-vest discomfort and complications.http://www.sciencedirect.com/science/article/pii/S2772529422000182 |
| spellingShingle | Massimimiliano Minardi Alessandro Narducci Giovanni Giulio Vercelli Christian Francesco Carlino Federico Griva Pier Federico Pretti Lag screws for reduction of bilateral lateral mass fractures due to spinal trauma Brain and Spine |
| title | Lag screws for reduction of bilateral lateral mass fractures due to spinal trauma |
| title_full | Lag screws for reduction of bilateral lateral mass fractures due to spinal trauma |
| title_fullStr | Lag screws for reduction of bilateral lateral mass fractures due to spinal trauma |
| title_full_unstemmed | Lag screws for reduction of bilateral lateral mass fractures due to spinal trauma |
| title_short | Lag screws for reduction of bilateral lateral mass fractures due to spinal trauma |
| title_sort | lag screws for reduction of bilateral lateral mass fractures due to spinal trauma |
| url | http://www.sciencedirect.com/science/article/pii/S2772529422000182 |
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