The spine journal : official journal of the North American Spine Society
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Atlantoaxial anterior transarticular screw fixation: a case series and reappraisal of the technique.
Atlantoaxial instability is commonly treated with C1-C2 fixation performed via posterior approaches. Although anterior transarticular screw (ATS) fixation, performed with a classic retropharyngeal approach, was described more than 10 years ago, the published literature still lacks a comprehensive analysis of the procedure and a real case series. ⋯ Although the procedure is still not widely known, ATS allows the effective and safe treatment of C1-C2 instability even in patients with systemic comorbidities. It offers several advantages over posterior approaches.
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Fusionless scoliosis surgery is frequently performed in children. Many studies have analyzed the effects of spinal growth modulation by tethering the anterior and anterolateral aspects of the spine in animal models. However, few studies have reported the disc health and spinal motion in spines with posterior unilateral elastic tethering. ⋯ Unilateral elastic tethering resulted in vertebral wedging and scoliosis. Although changes in collagen and MMP-3 distribution, proteoglycan synthesis, end-plate epiphysis, and disc thickness were observed, the tethered discs and end plates did not demonstrate gross morphologic signs of degeneration.