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DOI:    [Accepted]
Published online October 2, 2018.
The Transspinal Canal Screwing Technique for Atlantoaxial Anomalies: A Technical Note and 2 Case Reports
Kento Takebayashi1,2  , Motoo Kubota1, Masahito Yuzurihara1, Shigekuni Tachibana1, Takakazu Kawamata2
1Department of Spinal Surgery, Kameda Medical Center, Kamogawa, Japan
2Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan
Corresponding Author:  Kento Takebayashi
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Received: April 20, 2018   Revised: June 12, 2018   Accepted: June 23, 2018
Introduction It is difficult to treat atlanto-axial instability in cases with high riding vertebral artery or anomalies of craniocervical junction. We report two successful cases with trans-spinal canal screwing technique because of difficulty to perform conventional fixation methods. Case presentation Case1: A 78-year-old female suffered from progressive myelopathy due to severe spinal cord compression with congenital anomaly of craniovertebral junction. Bilateral trans-spinal canal screws from axis body with spondylolisthesis to dens were inserted by retracting dural sac medially after foramen magnum decompression and cervical laminoplasty. Case2: A 20-year-old man with spinal deformity for Leys-Dietz syndrome introduced to our hospital for treatment of syringomyelia. There was no obvious neurological deficit but spinal cord compression due to right atlanto-axial rotating dislocation was observed. Screw was inserted from the vertebral body of axis to right lateral mass of atlas via spinal canal after laminectomy of atlas.
Trans-spinal canal screwing technique is useful to treat atlantoaxial instability with difficulty of other fixation methods.
Keywords: Atlanto-axial subluxation; congenital anomaly; Trans-spinal canal screwing technique

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