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KMID : 0388720070140030187
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Journal of Korean Society of Spine Surgery
2007 Volume.14 No. 3 p.187 ~ p.191
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Revision of Atlantoaxial Fusion using Segmental Screw Fixation: Experience in Bilateral Posterior Arch Fracture of the Atlas Complicating Atlantoaxial Halifax Clamp Fixation - A Case Report -
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Seo Jae-Sung
Kim Kyeong-Hwan
Hong Soon-Woo
Yeom Jin-Sup
Park Kun-Woo
Chang Bong-Soon
Lee Choon-Ki
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Abstract
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A fracture of the posterior arch of the atlas is a rare complication of Halifax clamp fixation for atlantoaxial fusion. To the best of our knowledge, there is only one case reported reporting the English literature. Revision for this condition is challenging because of the difficulty in the surgical approach, internal fixation, and fusion. We report a case of bilateral fractures and nonunion of the posterior arch of the atlas and atlantoaxial nonunion after an atlantoaxial fusion procedure using Halifax clamp fixation, which resulted in persistent atlantoaxial instability and progressive myelopathy. Segmental screw fixation was performed using C1 lateral mass screws and C2 subarticular screws, along with intraarticular and extraarticular atlantoaxial inter-facet fusion.
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KEYWORD
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Atlantoaxial instability, Halifax clamp, Segmental screw fixation, Revision
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