The lasso technique for posterior C1-C2 fusion

Paul Klimo, Mandy Binning, Douglas L. Brockmeyer, Ronald I. Apfelbaum

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: Posterior atlantoaxial arthrodesis requires placement of a bone graft in a properly prepared environment that includes decorticated bony surfaces, compressive forces between graft and native bone, and limited motion. To achieve posterior atlantoaxial arthrodesis, various cable-and-graft constructs have been used, all of which require an intact posterior arch of C1. For patients who lack an intact arch owing to congenital, iatrogenic, or traumatic causes, we have devised the "lasso technique," which uses the remnants of the posterior arch of C1 for placement of the graft to achieve fusion isolated to C1-C2 or to be part of an occipitocervical construct. METHODS: A retrospective record review was conducted of all patients who underwent the lasso technique. Clinical and radiographic history, perioperative course, and time to fusion were recorded. We describe the technique in detail. RESULTS: During the last 13 years, we have used this technique successfully in five female and four male patients. The absent or incompetent posterior arch was a congenital defect in one patient, a result of prior surgical removal in four patients, and caused by fracture associated with prior failed fusion attempts in four other patients. All patients experienced successful fusion after an average of 6.8 months. CONCLUSION: Securing a bone graft in the absence of an intact C1 lamina is a challenge when a patient presents with atlantoaxial instability. We have devised the lasso technique to secure an interpositional C1-C2 graft using the remnants of the posterior atlantal arch. Although this technique has been required relatively infrequently, we have found it to be valuable and effective in our practice.

Original languageEnglish (US)
JournalNeurosurgery
Volume61
Issue number3 SUPPL.
DOIs
StatePublished - Sep 1 2007
Externally publishedYes

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Transplants
Arthrodesis
Bone and Bones
alachlor
History

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Surgery

Cite this

Klimo, P., Binning, M., Brockmeyer, D. L., & Apfelbaum, R. I. (2007). The lasso technique for posterior C1-C2 fusion. Neurosurgery, 61(3 SUPPL.). https://doi.org/10.1227/01.neu.0000289721.04836.b4

The lasso technique for posterior C1-C2 fusion. / Klimo, Paul; Binning, Mandy; Brockmeyer, Douglas L.; Apfelbaum, Ronald I.

In: Neurosurgery, Vol. 61, No. 3 SUPPL., 01.09.2007.

Research output: Contribution to journalArticle

Klimo, P, Binning, M, Brockmeyer, DL & Apfelbaum, RI 2007, 'The lasso technique for posterior C1-C2 fusion', Neurosurgery, vol. 61, no. 3 SUPPL.. https://doi.org/10.1227/01.neu.0000289721.04836.b4
Klimo, Paul ; Binning, Mandy ; Brockmeyer, Douglas L. ; Apfelbaum, Ronald I. / The lasso technique for posterior C1-C2 fusion. In: Neurosurgery. 2007 ; Vol. 61, No. 3 SUPPL.
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