ArticleJournal of craniovertebral junction & spine
Restoring stability at the craniovertebral junction using the Goel technique: Outcomes of posterior C1-C2 fixation in 216 patients.
Article in Journal of craniovertebral junction & spine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Atlantoaxial instability arising from diverse craniovertebral junction (CVJ) pathologies poses substantial surgical challenges because of complex regional biomechanics and proximity to critical neurovascular structures. Posterior C1-C2 fixation using the Goel-Harms technique is widely adopted; however, large institutional outcome data remain limited. Objective: The objective of this study was to evaluate the clinical and radiological outcomes, perioperative parameters, and complications following posterior C1-C2 fixation in patients with CVJ anomalies and atlantoaxial instability. Materials and Methods: A retrospective cohort study was performed of patients who underwent posterior C1 lateral mass-C2 pedicle screw fixation between January 2008 and December 2023 at a single tertiary center. Clinical outcomes were assessed using the Visual Analog Scale (VAS), Nurick grading system, and Oswestry Disability Index (ODI). Radiological evaluation included the atlantodental interval (ADI), clivus-canal angle, and standard craniometric lines. Perioperative variables, complications, and length of hospital stay were analyzed. Results: A total of 216 patients were included (mean age: 34.6 ± 5.2 years; 62.0% male). Traumatic pathology was the most common etiology (45.4%), followed by congenital (24.1%) and degenerative causes (16.7%). Significant postoperative improvement was observed in VAS (5.39 ± 1.68-1.46 ± 1.21), Nurick grade (3.68 ± 1.26-2.06 ± 0.87), and ODI (49.4 ± 12.2-22.19 ± 9.3) (all Conclusion: Posterior C1-C2 fixation using the Goel-Harms technique provides safe, reproducible, and effective stabilization, with significant clinical and radiological improvement in patients with atlantoaxial instability associated with CVJ anomalies.
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