[Posterior atlantoaxial fixation using vertex multiaxial screw system]

This study aims to assess the effectiveness and advantages of Vertex multiaxial screw system in use for stabilizing the atlanto-axial junction. The entry point of the atlas was located 18-20 mm lateral to the midline and 2.0 mm superior to the inferior border of posterior arch, and the direction of screw was chosen to be about 10 degrees medial to the sagittal plane and about 5 degrees cephalad to the transverse plane. In odontoid vertebra (C2), the direction of the drill bit was guided directly by the medial and superior aspect of the individual C2 pedicle. All screws were placed properly without incidence of nerve or blood vessel injury, and no complication appeared in operation and after surgery. All cases were followed up for an average of 9 months, all cases achieved well reposition and fixation of atlantoaxial joint, average JOA grade was 9.6 before preoperation and 15.9 after operation. Fixation of the atlantoaxial complex using Vertex multiaxial screw system seemed to be a reliable technique and should be considered a good alternative in atlantoaxial fusion. The technique could be used in young patiens.