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Review Article

Cervical Spine

Atlantoaxial Reconstruction: The Artful Evolution of Craniovertebral Junctional Spine Surgery
Sang Hoon Hwang, Seung Jun Ryu, Min Han Kim, Jong Koo Lee, Sun Woo Jang, Danbi Park, Chong Man Kim, Jin Hoon Park
Neurospine 2025;22(3):634-649.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550960.480

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Atlantoaxial Reconstruction: The Artful Evolution of Craniovertebral Junctional Spine Surgery
Neurospine. 2025;22(3):634-649.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550960.480
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Atlantoaxial Reconstruction: The Artful Evolution of Craniovertebral Junctional Spine Surgery
Neurospine. 2025;22(3):634-649.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550960.480
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The atlantoaxial (C1–2) junction is among the most technically demanding regions for cervical spine surgery owing to its complex osseoligamentous anatomy and proximity to critical neurovascular structures. Numerous posterior fixation constructs have been developed to optimize biomechanical rigidity and promote arthrodesis. Since Gallie’s introduction of posterior wiring with autologous bone grafts in 1939, evolving techniques have focused on enhancing fusion rates while minimizing risk to adjacent structures. This paper outlines the historical evolution of C1–2 posterior instrumentation, current fixation strategies, bone fusion techniques, and reduction methods. A systematic literature search identified 61 relevant studies on C1–2 fusion. Additional references were manually reviewed to provide a comprehensive context. Of these, 41 studies were narratively summarized to outline the historical and conceptual evolution of C1–2 fusion techniques, while the remaining 20 post-2000 studies on contemporary surgical modifications were systematically reviewed and tabulated for technical details and clinical outcomes. C1–2 fusion techniques have evolved significantly over time. Early methods primarily involved posterior wiring with autologous bone grafts, but later transitioned to rigid segmental fixation using pedicle screw constructs, resulting in improved fusion rates and clinical outcomes. Interarticular fusion, when concurrently performed, enhances the biological fusion environment, contributing to favorable clinical results. C1 lateral mass, posterior arch, pedicle screws and C2 pedicle, lamina screws give us much stronger stability and higher fusion rates. Interarticular fusion using local bone also gives us technical easiness guaranteeing high fusion rate overcoming inconvenience of wiring and iliac bone harvest. Interarticular height reduction and interarticular fusion should be discriminated.
  • 2,950 View
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  • 3 Web of Science

Original Articles

Intra-articular Distraction Versus Decompression to Treat Basilar Invagination Without Atlantoaxial Dislocation: A Retrospective Cohort Study of 54 Patients
Boyan Zhang, Maoyang Qi, Zong Xin, Yueqi Du, Can Zhang, Zhenlei Liu, Jian Guan, Zuowei Wang, Fengzeng Jian, Wanru Duan, Zan Chen
Neurospine 2023;20(2):498-506.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2244910.455

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Intra-articular Distraction Versus Decompression to Treat Basilar Invagination Without Atlantoaxial Dislocation: A Retrospective Cohort Study of 54 Patients
Neurospine. 2023;20(2):498-506.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2244910.455
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Intra-articular Distraction Versus Decompression to Treat Basilar Invagination Without Atlantoaxial Dislocation: A Retrospective Cohort Study of 54 Patients
Neurospine. 2023;20(2):498-506.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2244910.455
Close
Objective
The surgical management of basilar invagination without atlantoaxial dislocation (type B basilar invagination) remains controversial. Hence, we have reported the use of posterior intra-articular C1–2 facet distraction, fixation, and cantilever technique versus foramen magnum decompression in treating type B basilar invagination as well as the results and surgical indications for this procedure.
Methods
This was a single-center retrospective cohort study. Fifty-four patients who underwent intra-articular distraction, fixation, and cantilever reduction (experimental group) and foramen magnum decompression (control group) were enrolled in this study. Distance from odontoid tip to Chamberlain’s line, clivus-canal angle, cervicomedullary angle, craniovertebral junction (CVJ) triangle area, width of subarachnoid space and syrinx were used for radiographic assessment. Japanese Orthopedic Association (JOA) scores and 12-item Short Form health survey (SF-12) scores were used for clinical assessment.
Results
All patients in the experimental group had a better reduction of basilar invagination and better relief of pressure on nerves. JOA scores and SF-12 scores also had better improvements in the experimental group postoperation. SF-12 score improvement was associated with preoperative CVJ triangle area (Pearson index, 0.515; p = 0.004), cutoff value of 2.00 cm2 indicating the surgical indication of our technique. No severe complications or infections occurred.
Conclusion
Posterior intra-articular C1–2 facet distraction, fixation, and cantilever reduction technique is an effective treatment for type B basilar invagination. As various factors involved, other treatment strategies should also be investigated.

Citations

Citations to this article as recorded by  Crossref logo
  • Posterior Only Reduction and Fixation of The Basilar Invagination and Atlantoaxial Dislocation Secondary to Severe Rheumatoid Arthritis: A Technical Note
    Sadegh Bagherzadeh, Faramarz Roohollahi, Morteza Faghih jouibari, Mohammad Jafari, Toufigh Mohaddes Javadi
    European Spine Journal.2026; 35(4): 1891.     CrossRef
  • Hot topics and trends in adult Chiari malformation and basilar invagination: a bibliometric analysis [2005–2025]
    Youhai Xin, Zeyu Xie, Yanchun Guo, Zhesheng Chen, Weiwu Zheng, Wen Zhou, Zibi Xu, Weida Hong, Qinguo Huang
    Egyptian Journal of Neurosurgery.2026;[Epub]     CrossRef
  • A Surgical Technique Guide for C1–2 Fixation By the Cervical Spine Research Society
    Marc Prablek, Ashel C. Dsouza, Brian W. Su, Lee A. Tan
    Clinical Spine Surgery.2026;[Epub]     CrossRef
  • Impact of Additional Tonsillar Manipulation or Intra-articular Distraction on Syrinx Remission for Type B Basilar Invagination
    Qiang Jian, Zhe Hou, Xingang Zhao, Cong Liang, Yinqian Wang, Dongao Zhang, Kun Wu, Jichao Wang, Tao Fan
    Neurosurgery.2026;[Epub]     CrossRef
  • C2 Vertebra: An Enigma for Young Spine/Neurosurgeons
    Mayank Garg, Raghavendra K. Sharma, Vikas Janu, Mohit Agrawal, Ashutosh Jha, Pushpinder Khera, Deepak K. Jha
    Journal of Neurological Surgery Part B: Skull Base.2025; 86(01): 092.     CrossRef
  • Surgical Treatment of Basilar Invagination
    Ricardo V. Botelho, Oscar L. Alves, Geraldo Sá Carneiro, Zan Chen, Onur Yaman, Jutty Parthiban, Massimiliano Visocchi, Jörg Klekamp, Atul Goel, Mehmet Zileli
    Spine.2025; 50(11): 751.     CrossRef
  • Surgical Treatment of Basilar Invagination without Evident Atlantoaxial Instability (Type B) - A Systematic Review
    Andrei Fernandes Joaquim, Eloy Rusafa Neto, Leon Cleres Penido Pinheiro, Osmar Jose Santos de sMoraes, Eberval Gadelha Figueiredo, Carlos Gilberto Carloti, Roger Schimdt Brock
    Neurology India.2025; 73(3): 423.     CrossRef
  • Analysis of Failed Atlantoaxial Reduction: Causes of Failure and Strategies for Revision
    Boyan Zhang, Yueqi Du, Can Zhang, Maoyang Qi, Hongfeng Meng, Tianyu Jin, Guoqing Cui, Jian Guan, Wanru Duan, Zan Chen
    Orthopaedic Surgery.2024; 16(11): 2741.     CrossRef
  • Biomechanical Study of Atlanto-occipital Instability in Type II Basilar Invagination: A Finite Element Analysis
    Junhua Ye, Qinguo Huang, Qiang Zhou, Hong Li, Lin Peng, Songtao Qi, Yuntao Lu
    Neurospine.2024; 21(3): 1014.     CrossRef
  • From the Editor-in-Chief: Featured Articles in the June 2023 Issue
    Inbo Han
    Neurospine.2023; 20(2): 413.     CrossRef
  • 6,948 View
  • 230 Download
  • 8 Web of Science
  • 10 Crossref
Effectiveness of the Endplate Reduction Technique Combined With Bone Grafting for the Treatment of Thoracolumbar Fractures by Using Posterior Short-Segment Fixation
Jiguang Hou, Dong Ren, Yufeng Chen, Lindan Geng, Shuangquan Yao, Haotian Wu, Pengcheng Wang
Neurospine 2023;20(1):353-364.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2244980.490

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Effectiveness of the Endplate Reduction Technique Combined With Bone Grafting for the Treatment of Thoracolumbar Fractures by Using Posterior Short-Segment Fixation
Neurospine. 2023;20(1):353-364.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2244980.490
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Effectiveness of the Endplate Reduction Technique Combined With Bone Grafting for the Treatment of Thoracolumbar Fractures by Using Posterior Short-Segment Fixation
Neurospine. 2023;20(1):353-364.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2244980.490
Close
Objective
This study aimed to examine the effect of the endplate reduction (EPR) technique combined with bone grafting for treating thoracolumbar burst fractures using posterior short-segmental fixation.
Methods
Patients with thoracolumbar fractures admitted between January 2018 and October 2021 were retrospectively analyzed, and those meeting the criteria were assigned to the EPR group and the intermediate screws (IS) group. The vertebral wedge angle (VWA), Cobb angle (CA), anterior vertebral body height (AVBH), middle vertebral body height (MVBH), upper endplate line (UEPL), upper intervertebral angle (UIVA), and upper intervertebral disc height (UIDH) indices were examined and compared preoperatively, first day postoperatively, as well as at 12 months postoperatively.
Results
The result indicated that the EPR group achieved better MVBH reduction (p < 0.001), UEPL reduction (p < 0.001), vertebral body fracture healing (p = 0.006), as well as implant breakage (p = 0.04) than the IS group; VWA (p < 0.001), CA (p = 0.005), AVBH (p < 0.001), MVBH (p < 0.001), UEPL (p < 0.001), and UIDH (p < 0.001) were lost after reduction less than those in the IS group. There was no significant difference in operative time (p = 0.315) and intraoperative bleeding (p = 0.274) between the 2 groups.
Conclusion
The EPR group achieved better results in repositioning and maintaining MVBH and endplate morphology, with less correction loss after the reduction of the VWA, CA, AVBH, and endplate morphology. The EPR group exhibited a better healing pattern after vertebral fracture and disc degeneration was better relieved.

Citations

Citations to this article as recorded by  Crossref logo
  • Thoracolumbar burst fractures: robot-assisted mono-segment fixation with vertebral body grafting versus short-segment fixation — a propensity score-matched cohort study
    Junjie Qiao, Yuyu Fan, Ruizhao Zhao, Xinyao Lv, Xiutong Fang
    European Spine Journal.2026;[Epub]     CrossRef
  • Aktuelle operative Therapiekonzepte traumatischer Frakturen der BWS und LWS knochengesunder Erwachsener
    Ulrich Spiegl, Robert Pätzold, J. Krause, Mario Perl
    Die Unfallchirurgie.2025; 128(3): 167.     CrossRef
  • Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation
    Hai-qiang Shen, Yun-qin Xu, You-rong Yao, Qi Liu, Lin-ying Zhou, Xiao-jie Chen, Xiao-hong Lu, Xing Zhao, Yong Tang
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • Efficacy evaluation of minimally invasive particle implantation in treating head and neck malignancies under different guidance methods: a propensity score matching analysis study
    Qing Yan, Xin Li
    World Journal of Surgical Oncology.2025;[Epub]     CrossRef
  • A comparative analysis of three distinct approaches for the management of type A1 traumatic thoracolumbar fractures: a retrospective cohort study with a minimum 6-year follow-up
    Jiangtao Wang, Huiming Yang, Mario Ganau, Yuhang Wang, Junxian Miao, Liang Yan, Biao Wang
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • Effect of screw insertion depth into fractured vertebrae in the treatment of thoracolumbar fractures
    Jinghuai Wang, Dong Ren, Lindan Geng, Yufeng Chen, Shuangquan Yao, Pengcheng Wang
    Journal of Orthopaedic Surgery and Research.2024;[Epub]     CrossRef
  • 6,568 View
  • 201 Download
  • 8 Web of Science
  • 6 Crossref
Technique of Distraction, Compression, Extension, Reduction to Reduce and Realign Old Displaced Odontoid Fracture From Posterior Approach: A Novel Technique
P. Sarat Chandra, Raghu Samala, Ramesh Doddamani, Satish Verma, Pankaj Singh, Mahendra Singh Chauhan
Neurospine 2023;20(1):393-404.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2244460.230

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Technique of Distraction, Compression, Extension, Reduction to Reduce and Realign Old Displaced Odontoid Fracture From Posterior Approach: A Novel Technique
Neurospine. 2023;20(1):393-404.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2244460.230
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Technique of Distraction, Compression, Extension, Reduction to Reduce and Realign Old Displaced Odontoid Fracture From Posterior Approach: A Novel Technique
Neurospine. 2023;20(1):393-404.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2244460.230
Close
Objective
Chronic ‘displaced’ displaced type II fractures, though uncommon, are difficult to manage. They usually require a transoral procedure followed by a posterior instrumented fusion. We describe here, a new method to reduce the fractured displaced odontoid using a posterior cervical approach only.
Methods
Prospective and observational, n = 14 had a ‘displaced and irreducible’ old fracture dens causing cord compression (type I, 1; type II, 13). They underwent a novel technique to reduce the fracture. The C1 arch was first drilled and removed. The C1 lateral masses on both sides were then drilled completely and a spacer was placed between the occiput and C2 facet. Following this, an intraoperative reducing maneuver was performed, utilizing the spacer as a fulcrum, and then achieving complete reduction and realignment.
Results
All patients improved clinically (mean Nurick preoperative score: 4.07 ± 0.8; the postoperative score was 1.3 ± 0.4). The mean correction in effective canal diameter was 74.3% ± 9.5% and the mean correction in actual canal diameter was 77% ± 8.7%. Solid bone fusion was demonstrated in 12 patients with at least 1-year follow-up (follow-up range, 12–35 months; mean, 21.8 ± 9.8 months).
Conclusion
The new described modification of distraction, compression extension, and reduction seems to be effective for ‘displaced’ chronic fracture dens with cord compression. It avoids additional transoral surgery in these patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Endoscopic-assisted anterior transarticular screw fixation and arthrodesis for atlantoaxial instability via a retropharyngeal approach: technical note and preliminary clinical outcomes
    Shian Liao, Zhaojie Qin, Abu Moro, Fanyue Zeng, Jinsong Yang
    North American Spine Society Journal (NASSJ).2026; 26: 100881.     CrossRef
  • Impact of Fracture Deficit Volume on Fusion Success in Anterior Odontoid Screw Fixation
    JinWoo Jung, Young San Ko, Yu Sung Yoon, Dae-Chul Cho
    Neurospine.2025; 22(3): 859.     CrossRef
  • Posterior‐Only Approach for Management of Complete Posterior Displaced Type II Odontoid Fracture
    Seyed Reza Mousavi, Majid Reza Farrokhi, Hamid Jangiaghdam, Mohammadhadi Amir Shahpari Motlagh, Jochen Tüttenberg
    Case Reports in Surgery.2024;[Epub]     CrossRef
  • Controversies in the Management of Type II Odontoid Fractures
    Abhiraj D. Bhimani, James S. Harrop, Emery Monnig, Yehia Elkersh, John K. Houten
    Clinical Spine Surgery.2024; 37(9): 372.     CrossRef
  • 6,884 View
  • 216 Download
  • 5 Web of Science
  • 4 Crossref

Review Article

Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Mehmet Zileli, Enrique Osorio-Fonseca, Nikolay Konovalov, Carlos Cardenas-Jalabe, Stanislav Kaprovoy, Sergey Mlyavykh, Artur Pogosyan
Neurospine 2020;17(4):710-722.   Published online December 31, 2020
DOI: https://doi.org/10.14245/ns.2040282.141

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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):710-722.   Published online December 31, 2020
DOI: https://doi.org/10.14245/ns.2040282.141
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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):710-722.   Published online December 31, 2020
DOI: https://doi.org/10.14245/ns.2040282.141
Close
Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.

Citations

Citations to this article as recorded by  Crossref logo
  • Spine Trauma Resource Priorities in Sub-Saharan Africa: A Delphi Approach
    Charlotte F. Wahle, Chellandra Samuels, Shravya Kakulamarri, Babapelumi Adejuyigbe, Trisha Tee, Francisco Gomez Alvarado, Saam Morshed, Ashraf N. El Naga, David W. Shearer, David Gendelberg
    Global Spine Journal.2026; 16(3): 1501.     CrossRef
  • A prediction model for postoperative respiratory failure in patients with traumatic cervical spinal cord injury using interpretable machine learning
    Miao Yu, Hui Xing, Tao Jiang, Chao Zhang, Xianjun Ren, Minghan Liu, Changqing Li
    European Spine Journal.2026; 35(2): 959.     CrossRef
  • Clinical Guidelines and Their Role in Trauma-related Cervical Spine Imaging
    Masis Isikbay, Jason Talbott
    Radiology.2026;[Epub]     CrossRef
  • Computer-vision based recognition of cervical spine stabilization during trauma resuscitation
    Mary S. Kim, Sifan Yuan, Genevieve J. Sippel, Aaron H. Mun, Dylan W. Arkowitz, Ivan Marsic, Randall S. Burd
    Injury.2026; 57(2): 112951.     CrossRef
  • Variations in Managing Acute Spinal Cord Injury in the North American Clinical Trials Network and Partner Institutes
    Teleale Fikru Gebeyehu, Zachary Sokol, James D. Guest, Joseph D. Harrington, Ashmal Sami Kabani, Evan Fitchett, Alejandro Lopez, Stavros Matsoukas, Daniel Franco, Jack Jallo, Alexander R. Vaccaro, Muhammad Abd-El-Barr, Shekar N. Kurpad, Charles H. Tator,
    Global Spine Journal.2026;[Epub]     CrossRef
  • The Utility of Routine Postoperative Radiographs Following Surgical Treatment of Traumatic Cervical Spine Injuries
    Hershil Patel, Sapan Patel, Rohan I. Suresh, Vishal A. Khatri, Keerthana Srinivasan, Husni Alasadi, Evan Honig, Ryan Curto, Usman Zareef, Robin Fencel, Alexander Padovano, Louis J. Bivona, Daniel L. Cavanaugh, Eugene Y. Koh, Steven C. Ludwig, Julio J. Jau
    Journal of Clinical Medicine.2026; 15(6): 2231.     CrossRef
  • 3D-printed guide template for cervical stabilization surgery: A case report
    Koray Ur, Hatun Mine Şahin, Timurhan Aksoy, Ceren Kızmazoğlu, Reşat Serhat Erbayraktar
    Brain and Spine.2025; 5: 104267.     CrossRef
  • Cranial Nerve Dysfunction in Patients with an Occipital Condyle Fracture: Underdiagnosis and Clinical Relevance
    Madelon Thevis, Jolanda Derks, Thijs T.G. Jansen, Allard J.F. Hosman, Henricus P.M. Kunst
    Journal of Neurological Surgery Part B: Skull Base.2025; 86(06): e8.     CrossRef
  • Artificial Intelligence for Cervical Spine Fracture Detection: A Systematic Review of Diagnostic Performance and Clinical Potential
    Wongthawat Liawrungrueang, Watcharaporn Cholamjiak, Arunee Promsri, Khanathip Jitpakdee, Sompoom Sunpaweravong, Vit Kotheeranurak, Peem Sarasombath
    Global Spine Journal.2025; 15(4): 2547.     CrossRef
  • Evaluación de los recursos de atención de trauma en hospitales de media y baja complejidad de Cali, Colombia: un estudio observacional multicéntrico
    María Camila Arango-Granados, Valentina Muñoz-Patiño, María F. Escobar-Vidarte, Julio C. Diez-Sepúlveda, Cristhian Camilo Rojas-Perdomo, Andrés Gempeler, Leidy Johanna Hurtado-Bermúdez, Sebastián Luna-Delgado, Julián Alejandro Rivillas
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    Nicolò Marchesini, Andreas K. Demetriades, Oscar Alves, Riya Mandar Dange, Harold Mauricio Choco, Edinson Dussan Lozada, Dumar Javier Figueredo Sanabria, Angélica Gamboa, Luz Llined Mendoza Victoria, Enoc Noscue Montealegre, Jonathan A. Pardo Carranza, Jo
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    Nur Amelia S Shaharudin, Olivia A Dunseath, Nur Aina Azmi, Ning Yee Aun
    Cureus.2025;[Epub]     CrossRef
  • Traumatic bilateral cervical facet dislocation:a comprehensive review and evidence-based treatment algorithm
    Imran Z. Haq, Michael G. Fehlings, Alexander R. Vaccaro, Navin R. Furtado, Biao Wang, Pavan Upadhyayula, Jesus LaFuente, Adrian T. C. Casey, James B. Allibone, Mario Ganau
    European Spine Journal.2025;[Epub]     CrossRef
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    Camille Martin, Patrick Boissy, Mathieu Hamel, Karina Lebel
    Sensors.2024; 24(4): 1055.     CrossRef
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    William Robert Leeper, Nicholas James
    Surgical Clinics of North America.2024; 104(2): 293.     CrossRef
  • Where Do We Stand on Cervical Spine Immobilisation? A Questionnaire among Prehospital Staff
    Pascal Gräff, Lisa Bolduan, Christian Macke, Jan-Dierk Clausen, Stephan Sehmisch, Marcel Winkelmann
    Journal of Clinical Medicine.2024; 13(8): 2325.     CrossRef
  • Airway management for individuals with suspected or confirmed traumatic cervical spine injuries: A comprehensive review and analysis
    Debas Yaregal Melesse, Tadesse Teshale Tesema, Zemenay Ayinie Mekonnen, Wubie Birlie Chekol
    Perioperative Care and Operating Room Management.2024; 35: 100390.     CrossRef
  • Immobilization protocols for the treatment of cervical spine fracture: a scoping review
    Akhilesh Bhushan, Alexa Beland, Chantelle Poelstra, Jessica Butterfield, Marina Angel, Tiffany Cheung, Emma Plater, Daipayan Guha, Markian Pahuta, Luciana G. Macedo
    The Spine Journal.2024; 24(9): 1571.     CrossRef
  • Trends in Spinal Orthosis Utilization Among Patients Insured Through Medicare Part B
    Nikhil Dholaria, Isabel Bauer, James Kelbert, Giovanni Barbagli, Annemarie Pico, Courtney Deaver, Esteban Quiceno, Kristin Nosova, Amna Hussein, Julie Mayeku, Diego T. Soto Rubio, Ibrahim A. Alhalal, Endgel Heinzmann, Niels Pacheco, Abdullah Al-Arfaj, Cha
    Spine.2024; 49(16): 1171.     CrossRef
  • 2022 Systematic Review of Evidence-Based Guidelines for Prehospital Care
    Christian Martin-Gill, Kathleen M. Brown, Rebecca E. Cash, Rachel M. Haupt, Benjamin T. Potts, Christopher T. Richards, P. Daniel Patterson
    Prehospital Emergency Care.2023; 27(2): 131.     CrossRef
  • Pedicle Screw Fixation for Hemiplegia and Bilateral Hypoesthesia Due to C2-C3 Spinal Fracture Dislocation
    IGLNA Artha Wiguna, I Ketut Suyasa, Hans K Nugraha
    JBJS Case Connector.2023;[Epub]     CrossRef
  • Spine Bracing: When to Utilize—A Narrative Review
    John L. Cerillo, Alexander N. Becsey, Chai P. Sanghadia, Kevin T. Root, Brandon Lucke-Wold
    Biomechanics.2023; 3(1): 136.     CrossRef
  • Reduction of Lower Cervical Facet Dislocation: A Review of All Techniques
    Ke Liu, Zhengfeng Zhang
    Neurospine.2023; 20(1): 181.     CrossRef
  • Lesiones vertebrales postraumáticas
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Clinical Articles

Mini-open PLIF for Moderate to High Grade Spondylolisthesis: Technique to Achieve Spontaneous Reduction
Se Ho Jeong, Hyeun Sung Kim, Seok Won Kim
Korean J Spine 2015;12(4):251-255.   Published online December 31, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.4.251

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Mini-open PLIF for Moderate to High Grade Spondylolisthesis: Technique to Achieve Spontaneous Reduction
Korean J Spine. 2015;12(4):251-255.   Published online December 31, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.4.251
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Mini-open PLIF for Moderate to High Grade Spondylolisthesis: Technique to Achieve Spontaneous Reduction
Korean J Spine. 2015;12(4):251-255.   Published online December 31, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.4.251
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Objective

The purpose of this study was to evaluate the surgical technique and outcome of mini-open posterior lumbar interbody fusion (PLIF) under circumferential releasing technique.

Methods

Fourty patients who underwent mini-open PLIF using the percutaneous screw fixation system for Meyerding Grade II spondylolisthesis or more were retrospectively studied. After complete circumferential release, the slipped vertebrae would tend to obtain spontaneous reduction, and with compressive force by percutaneous screw fixation, additional reduction could be achieved. The radiological measurements including slippage reduction, disc height, restoration of lumbar lordotic angle and focal segmental angle were analyzed. The clinical outcome was assessed using the visual analog scale (VAS) and low back outcome score (LBOS), and procedure related complications were also analyzed.

Results

Slippage percentage was improved from 38.0±12.6% to 9.3±7.8% and lumbar lordotic angle was changed from 43.0±13.8° to 48.2±10.3°. Focal segmental angle improved from 10.1±8.5° to 15.9±6.0°. The mean LBOS and mean pain score were also improved significantly. Complications included one case of medial penetration of pedicle border and two cases of transient radiculopathy. However, there were no signs of neurological aggravation or fusion failure during the follow-up period.

Conclusion

Mini-open PLIF using the percutaneous screw fixation following complete circumferential release can be safe and effective treatment for even moderate to severe grade spondylolisthesis.

Citations

Citations to this article as recorded by  Crossref logo
  • Percutaneous lumbar interbody fusion and Cortoss cement bone augmentation in osteoporotic patients with anterolisthesis: A technical note
    R. Fiori, C. Di Donna, M. Forcina, A.U. Cavallo, A. D'Onofrio, L. Spritigliozzi, F. Garaci, R. Floris
    Interdisciplinary Neurosurgery.2023; 32: 101708.     CrossRef
  • Percutaneous transforaminal endoscopic discectomy in the treatment of senior patients with lumbar degenerative disc disease
    Jiayue Bai, Wei Zhang, Xiangzhou Liu, Jinghang Cheng, Xianzheng Wang, Wenyuan Ding, Yong Shen
    Experimental and Therapeutic Medicine.2018;[Epub]     CrossRef
  • Radiographic and Clinical Outcomes of Posterior Interbody Fusion for High-Grade Spondylolisthesis
    Jae Yoon Chung, Hyoung Yeon Seo, Sung Kyu Kim
    Journal of Korean Society of Spine Surgery.2016; 23(2): 93.     CrossRef
  • Radiographic and Clinical Outcomes of Posterior Interbody Fusion for High-Grade Spondylolisthesis
    Jae Yoon Chung, Hyoung Yeon Seo, Sung Kyu Kim
    Journal of Korean Society of Spine Surgery.2016; 23(2): 93.     CrossRef
  • 10,056 View
  • 118 Download
  • 4 Crossref
Slip Reduction Rate between Minimal Invasive and Conventional Unilateral Transforaminal Interbody Fusion in Patients with Low-Grade Isthmic Spondylolisthesis
Chang Hyun Oh, Gyu Yeul Ji, Jae Kyun Jeon, Junho Lee, Seung Hwan Yoon, Dong Keun Hyun
Korean J Spine 2013;10(4):232-236.   Published online December 31, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.4.232

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Slip Reduction Rate between Minimal Invasive and Conventional Unilateral Transforaminal Interbody Fusion in Patients with Low-Grade Isthmic Spondylolisthesis
Korean J Spine. 2013;10(4):232-236.   Published online December 31, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.4.232
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Slip Reduction Rate between Minimal Invasive and Conventional Unilateral Transforaminal Interbody Fusion in Patients with Low-Grade Isthmic Spondylolisthesis
Korean J Spine. 2013;10(4):232-236.   Published online December 31, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.4.232
Close
Objective

To compare the slip reduction rate and clinical outcomes between unilateral conventional transforaminal lumbar interbody fusion (conventional TLIF) and unilateral minimal invasive TLIF (minimal TLIF) with pedicle screw fixation for treatment of one level low-grade symptomatic isthmic spondylolisthesis.

Methods

Between February 2008 and April 2012, 25 patients with low-grade isthmic spondylolisthesis underwent conventional TLIF (12 patients) and minimal TLIF (13 patients) in single university hospital by a single surgeon. Lateral radiographs of lumbar spine were taken 12 months after surgery to analyze the degree of slip reduction and the clinical outcome. All measurements were performed by a single observer.

Results

The demographic data between conventional TLIF and minimal TLIF were not different. Slip percentage was reduced from 15.00% to 8.33% in conventional TLIF, and from 14.15% to 9.62% in minimal TLIF. In both groups, slip percentage was significantly improved postoperatively (p=0.002), but no significant intergroup differences of slip percentage in preoperative and postoperative were found. The reduction rate also not different between conventional TLIF (45.41±28.80%) and minimal TLIF (32.91±32.12%, p=0.318).

Conclusion

Conventional TLIF and minimal TLIF with pedicle screw fixation showed good slip reduction in patients with one level low-grade symptomatic isthmic spondylolisthesis. The slip percentage and reduction rate were similar in the conventional TLIF and minimal TLIF.

Citations

Citations to this article as recorded by  Crossref logo
  • Traumatic Vertebral Fracture in a Patient With Transforaminal Lumbar Interbody Fusion: A Rare Complication
    Wan-Chi Chiang, Tsung-Hsi Tu, Jau-Ching Wu, Wen-Cheng Huang, Chao-Hung Kuo
    Cureus.2021;[Epub]     CrossRef
  • Minimal-invasive transforaminale lumbale interkorporelle Fusion
    Christoph-Heinrich Hoffmann, Frank Kandziora
    Operative Orthopädie und Traumatologie.2020; 32(3): 180.     CrossRef
  • Clinical, radiological and functional results of transforaminal lumbar interbody fusion in degenerative spondylolisthesis
    Dr. Ghanshyam Kakadiya, Dr. Kushal Gohil, Dr. Yogesh Soni, Dr. Akash Shakya
    North American Spine Society Journal (NASSJ).2020; 2: 100011.     CrossRef
  • Reduction and monosegmental fusion for lumbar spondylolisthesis with a long tab percutaneous pedicle screw system: “swing” technique
    Bumsoo Park, Sung-Hyun Noh, Jeong-Yoon Park
    Neurosurgical Focus.2019; 46(5): E11.     CrossRef
  • Circumferential fusion: a comparative analysis between anterior lumbar interbody fusion with posterior pedicle screw fixation and transforaminal lumbar interbody fusion for L5–S1 isthmic spondylolisthesis
    Erik Y. Tye, Joseph E. Tanenbaum, Andrea S. Alonso, Roy Xiao, Michael P. Steinmetz, Thomas E. Mroz, Jason W. Savage
    The Spine Journal.2018; 18(3): 464.     CrossRef
  • Can Unilateral Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) Result in Sufficient Reduction in Spondylolisthesis?: A Comparison with Open TLIF and Bilateral MIS TLIF
    Ki-Hyoung Koo, Jangyun Lee, Jae-Hyun Kim
    Journal of Korean Society of Spine Surgery.2017; 24(2): 95.     CrossRef
  • Can Unilateral Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) Result in Sufficient Reduction in Spondylolisthesis?: A Comparison with Open TLIF and Bilateral MIS TLIF
    Ki-Hyoung Koo, Jangyun Lee, Jae-Hyun Kim
    Journal of Korean Society of Spine Surgery.2017; 24(2): 95.     CrossRef
  • Minimally Invasive Transforaminal Lumbar Interbody Fusion for Isthmic Spondylolisthesis: In Situ Versus Reduction
    Guoxin Fan, Guangfei Gu, Yanjie Zhu, Xiaofei Guan, Annan Hu, Xinbo Wu, Hailong Zhang, Shisheng He
    World Neurosurgery.2016; 90: 580.     CrossRef
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    Ali Fahir Ozer, Tuncer Suzer, Mehdi Sasani, Tunc Oktenoglu, Emrah Egemen
    Korean Journal of Spine.2016; 13(1): 37.     CrossRef
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    Do-Keun Kim, Hyunkeun Lim, Dae Cheol Rim, Chang Hyun Oh
    Korean Journal of Spine.2016; 13(2): 57.     CrossRef
  • 8,247 View
  • 61 Download
  • 10 Crossref

Case Report

Anterior Screw Fixation of Anteriorly Displaced Type III Odontoid Fracture Corrected by Transoral Digital Manipulation
Do-sung Lee
Korean J Spine 2013;10(2):101-103.   Published online June 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.2.101

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Anterior Screw Fixation of Anteriorly Displaced Type III Odontoid Fracture Corrected by Transoral Digital Manipulation
Korean J Spine. 2013;10(2):101-103.   Published online June 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.2.101
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Anterior Screw Fixation of Anteriorly Displaced Type III Odontoid Fracture Corrected by Transoral Digital Manipulation
Korean J Spine. 2013;10(2):101-103.   Published online June 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.2.101
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Type III odontoid fractures have been treated by several methods. In case of anteriorly displaced type III odontoid fracture which is not corrected by closed reduction, anterior screw fixation cannot be used. We report the first case of anterior screw fixation of anteriorly displaced type III odontoid fracture corrected by transoral digital manipulation.

Citations

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  • Clinical Results of Odontoid Fractures according to a Modified, Treatment-Oriented Classification
    Eui-Jin Cho, Se-Hoon Kim, Won-Hyung Kim, Sung-Won Jin, Seung-Hwan Lee, Bum-Joon Kim, Sung-Gon Ha, Sang-Dae Kim, Dong-Jun Lim
    Korean Journal of Spine.2017; 14(2): 44.     CrossRef
  • 8,273 View
  • 53 Download
  • 1 Crossref
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