ARTERIOVENOUS-FISTULA AS A COMPLICATION OF C1-2 TRANSARTICULAR SCREW FIXATION - CASE-REPORT AND REVIEW OF THE LITERATURE

A case is reported of a vertebral artery-to-epidural venous plexus fis tula as a complication of posterior atlantoaxial facet screw fixation. The use of transarticular screws to stabilize the C1-2 joint has beco me an increasingly popular fixation technique, most notably for atlant oaxial instability due to trauma or rheumatoid disease. Despite the fa ct that this approach is technically challenging, there have been few reports of complications associated with C1-2 transarticular fixation. Although damage to the vertebral artery is a documented hazard of tra nsarticular fixation at this level, a symptomatic arteriovenous fistul a resulting from the procedure has not been described previously. The etiology, presentation, and treatment of this unusual complication are discussed.