Brain and Spine Surgery



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Stabilization Of Post C. V. Junction

 


Overview

 


AAD is common. Trauma in our country is the commonest cause of AAD. Stabilization including occiput is a better construct for a good long term results. C1 and C2 alone can be stabilized by bilateral cortico cancellous lateral mass screws ( Magerl Technique) but inclusion of occiput in the process of fusion is better in our country where frequently carry loads on their heads.

The stabilization is carried out with a contoured metallic loup. 8 drill holes are made in the occipital bone 4 wires are passed, one through two holes. Sublaminar wires are passed through C1 and C2 on either side of the spinous processes. The contoured loup is fixed in position by tightening the wires around the loup. Cortico cancellous bone taken from the iliac crest is then laid down by onlay technique to achieve bony fusion.



The Advantages And Indications Are:


  • Improves Stability & Support
  • Alternative to grafts
  • One or more vertebral bodies can be substituted
  • Anchors between adjacent end plates of the vertebral bone
  • Hollow Design
  • Corrects misalignment by distraction
  • Distractable in situ
  • Anterior vertebral column is stabilized for load bearing


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Indications


  1. Tumor
  2. Post Traumatic Vertebral Deformity (Compression fracture, Burst fracture, subluxation)
  3. Osteoporotic compression fracture
  4. Acute traumatic fracture
  5. Spondylolisthesis
  6. Kyphoscoliosis
  7. Congenital Vertebral Anomaly
  8. Osteomyelitis, remote
  9. Interbody fusions for failed posterior instrumentation and fusion
  10. Interbody fusions for reconstructive spinal surgery









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