Anterior transarticular screw fixation for atlantoaxial arthrodesis: A report of two cases
The second case report is about a 68-year-old female patient who presented to the orthopedic out-patient clinic with a 3 years history of persistent right-sided axial neck and occipital pain. On presentation, she complained of severe pernicious neck pain that radiated to her occiput. On physical examination, she was hypesthetic in a C2 distribution. Objective motor strength was 4/5 in the right deltoid and 3/5 in the right shoulder internal/external rotators, consistent with her previous total shoulder replacement. CT [] and plain radiographs of the cervical spine demonstrated coronal deformity, severe right sided facet arthropathy at C1-2 and congenital fusions at C2-3, C3-4 and C4-5. Attempted conservative management included C1-2 facet injections and occipital nerve block, which provided only transient relief. The association of Klippel-Feil syndrome with anomalous vertebral artery anatomy that frequently follows a less predictable course,[] made an anterior approach for C1-2 fusion an appealing surgical option.\nThe patient was treated with anterior transarticular C1-2 fusion []. At 6 months follow-up, the patient reported 90% improvement in her pre-operative symptoms of neck pain and paresthesia [].