One-stage posterior decompression and stabilization of the atlanto-axial-subaxial cervical spine

Objective: The aim of this study is to evaluate the results of decompression and stabilization of the unstable atlanto-axial-subaxial cervical spine using a one-stage posterior approach surgical method. Methods: Eight patients included seven men and one woman, whose ages ranged from 27 to 74 years, with an average of 51.8 years with either C1-2-3 or C1-2-3-4 instability were included in this study. All patients received a one-stage operation, including posterior approach C1-C2 transarticular screws and subaxial cervical spine lateral mass plates and screws fixation with or without cervical laminectomy. Results: Eight to eighteen months after the surgery, the follow-up revealed neither neurological deterioration nor hardware failure. The outcome was satisfactory. Conclusions: The combination of C1-C2 transarticular screws with subaxial lateral mass plates and screws fixation does not require the lamina as a stabilizing anchor. In cases of incompetence of the posterior elements or if a decompression laminectomy procedure is necessary, posterior decompression and instrumentation fixation can be performed in a one-stage surgery. We believe that the C1-C2-transarticular screws-subaxial lateral mass plates and screws procedure is a good alternative method in treating the unstable atlanto-axial-subaxial cervical spine.