Postoperative complications of Goel-Harms C1-C2 screw-rod fixation technique for C1-C2 instability after C2 nerve sacrifice, a prospective study over two years follow up. (June 2021)

• Record Type: Journal Article
• Authors: Rezvani, Majid; Sourani, Arman; Nikzad, Hamid
• Is Part Of: Journal of clinical neuroscience. Volume 88(2021)
• Page Start: 52
• Page End: 56
• Publication Date: 2021-06
• Subjects: Atlantoaxial instability -- Goel-Harms technique -- C2 root sacrifice; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2021.03.012
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: 27 c1-c2 fixation using Goel-Harms technique was performed. We recorded demographic medical data and evaluated the complications. Occipital anesthesia/paresthesia and neck pain were most common post-operative complications which reduced overtime. Abstract: Background: Atlantoaxial instability is mainly caused by trauma. C2 nerve is usually needed to be sacrificed for adequate exposure of the lateral mass and screw insertion. Objectives: This study aimed to investigate the clinical outcome of postoperative complications of C1 and C2 screw-rod fixation using the Goel-Harms technique for C1-C2 instability after sacrificing the C2 nerve root. Methods: Amongst forty patients with C1-C2 pathology, twenty-seven cases were enrolled into the study, then variables, including age, sex, primary pathology, operation duration, postoperative pain, paresthesia, anesthesia, and other specific conditions, were documented. Data analyzed by an expert biostatistician. p-value < 0.05 was considered significant. Results: Regardless of gender, the most postoperative adverse effect was occipital anesthesia (81.5%). Most of the patients (63%) had both occipital pain and anesthesia one-month post-surgery. At 3- and 6-months post-surgery, occipital pain and anesthesia were seen in 40.7% and 14.8%, respectively. Conclusion: The most common postoperative adverse effect of C2 nerve root scarification after C1-C2 fixation is occipital anesthesia followed by occipital paresthesia and pain, which are reduced in severity over time.