C1-2 Fusion in Atlantoaxial Dislocation in Patients with Ankylosing Spondylosis: Tips and Tricks

A BSTRACT Atlantoaxial dislocation (AAD) in patients with ankylosing spondylosis is a complex condition and requires an appropriate approach to reduce the risk of complications, especially during patient positioning, repositioning, and screw placement on C1 and C2. C1-2 fusion is among the most effective techniques for stabilizing this dislocation; however, the complexity of the procedure warrants careful consideration. This study aims to evaluate the effectiveness of C1-2 fusion in patients with ankylosing spondylosis who have AAD and provide practical tips and tricks to improve surgical outcomes. We reported a single rare case of AAD in patients with generalized spinal stiffness or ankylosing spondylosis. Difficulties begin during anesthesia in the form of difficulty intubating the patient when maintaining C-spine control. The challenge continues when positioning the patient in a prone position until a closed reduction is carried out to correct the dislocation first. Continued, open reduction, and fixation with C1 and C2 screws are quite difficult. Surgical results showed that C1-2 fusion had a high success rate in stabilizing AAD in patients with ankylosing spondylosis. Practical tips and tricks include selecting the right bone fitting technique, using appropriate surgical aids, and monitoring the patient after surgery to prevent complications. C1-2 fusion in this patient is an effective method for treating AAD in patients with ankylosing spondylosis. The practical tips and tricks described in this report can help improve surgical outcomes and reduce the risk of complications.