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Treatment of fractures of the axis (C2)



If the axial vertebral fractures are at the bottom or the middle area, they are often not stable and require fixation.

In this case, until now there were two operating method:

  • Access from the rear side of the neck (posterior) allows fixation between the first and second cervical vertebrae using bone graft from the iliac crest. This method has justified itself and it provides high stability. One drawback of this method is fully limited movement between first and second cervical vertebrae, which in turn leads to loss of rotation capacity by 30-40%.
  • Osteosynthesis with the front side of the neck (anterior). With this method, a single screw is entered into the axis of the axis. This ensures perfect fixation of bone without a consequent loss of rotatory power. From the standpoint of surgery this method compared with other operating method is less laborious. In this case, however, requires the simultaneous use of two video amplifier, whose number is often limited. Also, the location I set screw with video amplifier while the surgeon is no direct view of the place, because the source input is very far from the point of entry.

Minimally invasive (endoscopic) neurosurgical spinal surgery - Treatment of fractures of the cervical vertebra in Moscow

Anatomy cranio-occipital junction.


Recommended operational method for endoscopically assisted treatment of fractures of the axis

To limit the use of X-ray video amplifier can be used AR-amplifier (posterior / anterior). The image is recorded only after positioning the blade retractor. In the process of intervention used lateral perspective, to ensure perfect control of the screw. AP-image (the image front and back) necessary to verify the position of K-strings before installing screws.

Minimally invasive (endoscopic) neurosurgical spinal surgery - Treatment of fractures of the cervical vertebra in Moscow

Fluorescent navigation.

To carry out this action, we prefer fluorescent navigation. Excellent resolution through the blade retractor conducting X-rays, as well as good positioning screw achieved using navigation in conjunction with a lateral x-ray images improves the reliability of this method. Therefore, we recommend video-assisted surgery, which has two advantages:

  • On the one hand the possibility of sufficient illumination surgical field
  • On the other hand easier identification of the middle spine in order to install screws for osteosynthesis

Retractor blade is made of metallic material, conducting X-rays in order to achieve improved image video amplifier. The end of the retractor blade is curved so that the visibility provided by the surgical field, as well as adequate follow-up optical inspection. This also applies direct the endoscope with the direction of gaze 0 °. Retractor blade can be fixed temporarily on the bone with two metal rods. The handle is in an upright position with respect to an axis that does not restrict the movement of a surgeon.


If you have any questions, you can specify them with our neurosurgeon or a neurologist on the phone: (499) 130–08–09



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