A custom-made device-omega loop for posterior atlantoaxial fixation

Our experience with 17 patients of atlantoaxial instability treated with omega loop fixation, a custom-made device, is described. Various methods of fixation and fusion for atlantoaxial instability have been devisd and used successfully. However, the search for the most appropriate method of fixation continues. We conducted a retrospective review of patients with posterior stabilization of the upper cervical spine utilizing the omega loop which is made by bending a 2.0-2.4 mm K-pin into an omega shape, which fits the contour of individual lamina. The patients represent a mix of victims of motor vehicle- and sport-related trauma, falls, rheumatoid subluxation, os odontoideum and ankylosing spondylitis. 15 patients had good results (i.e. stable fusion, stabilization or regression of symptoms); the only one who did not develop stable union was a case of os odontoideum, while another patient died from pneumonia unrelated to the surgery. Our fusion rate being 93.8% (15/16) shows that omega loop fixation is a safe and effective method for the posterior stabilization of cervical spinal instability. When compared with other forms of instrumentation which achieve similar results, the use of omega loop fixation is very cost- effective.