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PubMed1982

[Lateral atlanto-axial arthrodesis (author's transl)].

The authors describe the surgical technique of atlanto-axial fixation using a bilateral lateral approach. The cartilage of the articular processes of C1 and C2 are excised and the joints grafted. A screw fixation of the articular processes is performed. 8 cases are reported.

Arthrodesis↗
PubMed1983

[Surgical approach to the 3rd segment of the vertebral artery by a paramedian posterior route].

Following an anatomical study of the lateral suboccipital region, the authors have devised an approach to the third segment of the vertebral artery, from C2 to the foramen magnum, which enabled them to treat an arteriovenous fistula in C1 while preserving the vertebral artery. The different operative stages and anatomical features are described. The simplicity and safety of this approach should encourage surgeons to use it.

Arteriovenous Fistula↗
PubMed1983

[Atloido-axoid surgery by a transoral approach].

The author has approached 18 atlanto-axial joints in 15 years by a transoral approach. Fourteen of the lesions were post traumatic, two congenital, one rheumatoid and one a tumour. It is concluded that the approach is a valuable one provided that there is adequate surgical technique, good antiseptic preparation, antibiotic therapy, provisional peroperative tracheostomy and special retractors. Use of adequate suture is also important. In some cases, magnification was needed. Medullary monitoring may also be helpful. The author estimates that the approach is more effective than extrabuccal techniques since it allows a direct exposure of the lesion. Large excisions are possible followed by reconstruction and grafting. It also allows screw fixation of the odontoid process. Two patients among earlier cases became infected but without serious long-term complications. Remaining cases have uncomplicated follow-up.

Adult↗