Reduction and ring fixation of instable C1 fractures with monoaxial pedicle screws

Abstract

Introduction: Ring fixation of C1 can be performed using pedicle screws and a rod in case of unstable Jefferson or lateral mass fractures of C1. Materials and methods: In a case series of three patients, we stabilized C1 fractures surgically using a modified technique of C1 ring fixation by using monoaxial instead of polyaxial screws. Functional outcome and pain was recorded postoperatively. Results: In this very small case series, we observed good results concerning pain and functional outcome. All fractures were bony healed within 13 weeks. In one case, a screw penetrated the spinal canal and had to be repositioned. A mild irritation of C2 nerve root occurred in two cases postoperatively. Conclusion: C1 Ring fusion with monoaxial screws provides a good ability to reduce the fracture indirectly by the screws and the rod itself.