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Instrumented reduction of a fixed C1–2 subluxation using occipital and C2/C3 fixation: A case report

Clifton Meals, MD, Rachel Harrison, MD, Warren Yu, MD, Joseph O'Brien, MD

Department of Orthopedics, George Washington University Medical Center, Washington, DC

Abstract 

Background

Different strategies exist for reduction of the cervical spine. Placement of C1 lateral mass screws is a powerful technique but may be impossible in a degenerative or revision setting. We report the open, posterior-only, and instrumented reduction of a fixed C1–2 subluxation using occipital and C2/C3 fixation. The patient had rheumatoid arthritis and had undergone previous surgery of the cervical spine.

Methods

We performed a retrospective chart review and focused appraisal of the literature.

Results

Satisfactory reduction was achieved with this infrequently reported technique.

Conclusions/Level of Evidence

Spine surgeons may consider the described procedure a viable treatment alternative in problematic subluxations of the cervical spine. Level V.

keywords: 
Cervical Spine, Subluxation, Reduction, Instrumented, Rheumatoid arthritis
Volume 7
doi: 
10.1016/j.ijsp.2013.01.002