TY - JOUR
T1 - Atlantoaxial Joint Distraction and Fusion with DTRAX Intra-Articular Cages
T2 - A Cadaveric Feasibility Study and Review of the Pertinent Literature
AU - Rapisarda, Alessandro
AU - Pennisi, Giovanni
AU - Montano, Nicola
AU - Della Pepa, Giuseppe Maria
AU - Ricciardi, Luca
AU - De-Giorgio, Fabio
AU - Visocchi, Massimiliano
AU - Olivi, Alessandro
AU - Polli, Filippo Maria
N1 - Funding Information:
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher Copyright:
© 2022
PY - 2022/10
Y1 - 2022/10
N2 - Purpose: Atlantoaxial joint distraction is a key procedure for the treatment of selected patients affected by basilar invagination (BI). In recent years, several authors have reported various techniques of distraction and fixation of the C1–C2 joint using different types of intra-articular spacers, with or without posterior fixation. We review the pertinent literature and propose a feasibility study on the use of a new device for the distraction of the C1–C2 joint aimed to the descent of the dens out of the foramen magnum suggesting its application on selected cases of BI. Methods: The GL-DTRAX Cervical Cage–SE is a cage approved by the Food and Drug Administration for distraction and fixation of subaxial cervical spine. Five adult cadaveric specimens were dissected surgically to evaluate the feasibility of DTRAX insertion inside the C1–C2 joint through a posterior approach. Results: The cages were uneventfully set into the C1–C2 intra-articular space of all samples without the need to sacrifice C2 nerve roots and ganglia. Postoperative cervical computed tomography scanning confirmed the correct fitting of the devices in every sample. Conclusions: This cadaveric study highlights the feasibility of the DTRAX cage as a C1–C2 intra-articular device producing a substantial distraction of atlantoaxial complex and suggesting a possible therapeutic role in selected cases of BI.
AB - Purpose: Atlantoaxial joint distraction is a key procedure for the treatment of selected patients affected by basilar invagination (BI). In recent years, several authors have reported various techniques of distraction and fixation of the C1–C2 joint using different types of intra-articular spacers, with or without posterior fixation. We review the pertinent literature and propose a feasibility study on the use of a new device for the distraction of the C1–C2 joint aimed to the descent of the dens out of the foramen magnum suggesting its application on selected cases of BI. Methods: The GL-DTRAX Cervical Cage–SE is a cage approved by the Food and Drug Administration for distraction and fixation of subaxial cervical spine. Five adult cadaveric specimens were dissected surgically to evaluate the feasibility of DTRAX insertion inside the C1–C2 joint through a posterior approach. Results: The cages were uneventfully set into the C1–C2 intra-articular space of all samples without the need to sacrifice C2 nerve roots and ganglia. Postoperative cervical computed tomography scanning confirmed the correct fitting of the devices in every sample. Conclusions: This cadaveric study highlights the feasibility of the DTRAX cage as a C1–C2 intra-articular device producing a substantial distraction of atlantoaxial complex and suggesting a possible therapeutic role in selected cases of BI.
KW - Basilar invagination
KW - DTRAX
KW - Feasibility cadaveric study
KW - Intra-articular C1–C2 spacers
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U2 - 10.1016/j.wneu.2022.07.077
DO - 10.1016/j.wneu.2022.07.077
M3 - Article
C2 - 35917923
AN - SCOPUS:85136508553
SN - 1878-8750
VL - 166
SP - 153
EP - 158
JO - World neurosurgery
JF - World neurosurgery
ER -