{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:27:35Z","timestamp":1787772455847,"version":"build-2784847793"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n Overview of the literature \u2013 Fractures of the C1 constitute 3%\u201313% of all cervical spine injuries in adults. Most isolated C1 fractures are stable and can be treated nonoperatively with external immobilization. Traditional surgical options for C1 fracture treatment are occiput-to-C2 fusion or C1 with lateral mass screws (LMSs). Purpose \u2013 The aim is to assess the management and perioperative complications of C1 fractures undergoing LMS fusion between fluoroscopy and computed tomography (CT)-guided navigation.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This was a retrospective multicenter study of data from the DWG-Register of patients who underwent operative treatment for C1 traumatic fracture with LMSs from January 2017 to September 2022. Inclusion criteria \u2013 traumatic injury and age > 18 years old.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In total, 202 patients with traumatic C1 fracture requiring spinal surgery were identified in the registry;\n n<\/jats:italic>\n = 175 (Group 1) were treated conventionally without CT-guided navigation and\n n<\/jats:italic>\n = 27 were treated with CT-guided navigation (Group 2). C1-LMS was principally performed by spine surgeons\n n<\/jats:italic>\n = 90 (53.4%) and\n n<\/jats:italic>\n = 72 (18.5%) by neurosurgeons in both the groups. Intraoperative adverse events were as follows: dural tear in group 1\n n<\/jats:italic>\n = 0 and in group 2\n n<\/jats:italic>\n = 1, vascular injury, with one case in group 1 and no cases in group 2. General complications were: cardiovasculars in group 1\n n<\/jats:italic>\n = 6 (3.4%) and Group 2\n n<\/jats:italic>\n = 4 (14.8%) (\n P<\/jats:italic>\n = 0.03), pulmonary complications in group1\n n<\/jats:italic>\n = 2 (1.1%) and\n n<\/jats:italic>\n = 9 in group 2 (33.3%) (\n P<\/jats:italic>\n < 0.001), stroke\n n<\/jats:italic>\n = 1 (0.57%) in group1 and\n n<\/jats:italic>\n = 4 in group 2 (14.8%) (\n P<\/jats:italic>\n < 0.001), gastrointestinal bleeding\n n<\/jats:italic>\n = 1 (0.57%) in group1 and no cases in group 2, renal insufficiency\n n<\/jats:italic>\n = 2 (1.1%) in group 1 and\n n<\/jats:italic>\n = 3 (11.1%) in group 2 (\n P<\/jats:italic>\n = 0.01) .One death was recorded in group 2 (3.7%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This series of 404 screws placed in 202 patients over 5 years who underwent two types of C1 fracture fixation had a considerably lower incidence of screw malposition and vertebral artery injury than has previously been reported in the literature. C1 screws can be safely placed with a low risk of vertebral artery and neurologic injury with and without CT-guided navigation support.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_36_24","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T15:04:22Z","timestamp":1716563062000},"page":"241-246","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Perioperative complications associated with fluoroscopy C1 lateral mass screw fixation (Goel technique) versus computed tomography-guided navigation technique: A review of 202 cases from the German Spine Registry (DWG-Register)"],"prefix":"10.4103","volume":"15","author":[{"given":"Juan Manuel","family":"Vinas-Rios","sequence":"first","affiliation":[{"name":"Department of Faculty of Medicine, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent J.","family":"Heck","sequence":"additional","affiliation":[{"name":"Department of Faculty of Medicine, University of Cologne, Cologne, Germany"},{"name":"Department of Spine Surgery, Sana Klinikum Offenbach, Offenbach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peer","family":"Eysel","sequence":"additional","affiliation":[{"name":"Department of Faculty of Medicine, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian Gottfried","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Faculty of Medicine, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Babasiz","sequence":"additional","affiliation":[{"name":"Department of Faculty of Medicine, University of Cologne, Cologne, 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