Occipitocervical Fixation Using Hooks and Screws for Upper Cervical Instability

Occipitocervical Fixation Using Hooks and Screws for Upper Cervical Instability AbstractOBJECTIVE:Occipitocervical fixation is used for the treatment of nontraumatic upper cervical instabilities. To date, plates have been fixed with screws or wires. However, these devices are not indicated in the treatment of patients with severe osteoporosis or in instances of significant thinning of the occipital bone. We performed a clinical trial of a new type of fixation that uses cervical interlaminar hooks and occipital claws with hooks or with screws (CCD type; Sofamor-Danek, Roissy, France) for the treatment of nontraumatic upper cervical instabilities.METHODS:Five women and one man ranging in age from 28 to 72 years (average age, 54 yr) were thus treated. The CCD type material had two rod plates and hooks allowing the proper placement of interlaminar and occipital claws. The occipital plate can also be directly screwed to the bone. Occipital hooks were used in four patients. The other two patients, who had occipitocervical congenital abnormalities that required an occipitocervical opening and an additional dural enlargement, underwent occipital screw fixation because of the previous opening of the foramen magnum. A cancellous iliac autograft allowed the usual fusion.RESULTS:No postoperative complications were observed, and all patients experienced significant improvement of their neck pain. Four patients had neurological symptoms. The condition of two patients improved, and the condition of the other two stabilized.CONCLUSION:No postoperative complications were observed, and all patients experienced significant improvement of their neck pain. Four patients had neurological symptoms. The condition of two patients improved, and the condition of the other two stabilized. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Occipitocervical Fixation Using Hooks and Screws for Upper Cervical Instability

Occipitocervical Fixation Using Hooks and Screws for Upper Cervical Instability

TECHNIQUE AND ASSESSMENTS Occipitocervical Fixation Using Hooks and Screws for Upper Cervical Instability Philippe Paquis, M .D ., Veronique BreuiI, M .D ., Michel Lonjon, M .D ., Liana Euller-Ziegler, M .D ., Patrick Grellier, M .D. Service de Neurochirurgie (PP, ML, PG), Centre Hospitalier U niversitaire de N ice, Hopital Pasteur, and Service de Rhumatologie (V B , LE-Z), Centre H ospitalier U niversitaire de N ice, Hopital I'Archet, N ice, France O B JE C T IV E S : O ccip itocervical fixation is used for the treatment of nontraum atic upper cervical instabilities. To date, plates have been fixed with screws or wires. H ow ever, these devices are not indicated in the treatment of patients w ith severe osteoporosis or in instances of significant thinning of the occipital bone. W e performed a clinical trial of a new type of fixation that uses cervical interlam inar hooks and occipital claws with hooks or with screws (C C D type; Sofamor-Danek, Roissy, France) for the treatment of nontraum atic upper cervical instabilities. M E T H O D S : Five women and one man ranging in age from 28 to 72 years (average age, 54 yr) w ere thus treated. The C C D type material had two rod plates and hooks allowing the proper placement of interlam inar and occipital claws. The occipital plate can also be directly screwed to the bone. O ccip ital hooks w ere used in four patients. The other two patients, who had occipitocervical congenital abnormalities that required an occipitocervical opening and an additional dural enlargement, underwent occipital screw fixation because of the previous opening of the foramen magnum. A cancellous iliac autograft allowed the usual fusion. RESULTS: No postoperative complications were observed, and all patients experienced significant improvement of their neck pain. Four patients had neurological symptoms. The condition of tw o patients improved, and the condition of the other two stabilized. C O N C L U S IO N : This report confirms the...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199902000-00042
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:Occipitocervical fixation is used for the treatment of nontraumatic upper cervical instabilities. To date, plates have been fixed with screws or wires. However, these devices are not indicated in the treatment of patients with severe osteoporosis or in instances of significant thinning of the occipital bone. We performed a clinical trial of a new type of fixation that uses cervical interlaminar hooks and occipital claws with hooks or with screws (CCD type; Sofamor-Danek, Roissy, France) for the treatment of nontraumatic upper cervical instabilities.METHODS:Five women and one man ranging in age from 28 to 72 years (average age, 54 yr) were thus treated. The CCD type material had two rod plates and hooks allowing the proper placement of interlaminar and occipital claws. The occipital plate can also be directly screwed to the bone. Occipital hooks were used in four patients. The other two patients, who had occipitocervical congenital abnormalities that required an occipitocervical opening and an additional dural enlargement, underwent occipital screw fixation because of the previous opening of the foramen magnum. A cancellous iliac autograft allowed the usual fusion.RESULTS:No postoperative complications were observed, and all patients experienced significant improvement of their neck pain. Four patients had neurological symptoms. The condition of two patients improved, and the condition of the other two stabilized.CONCLUSION:No postoperative complications were observed, and all patients experienced significant improvement of their neck pain. Four patients had neurological symptoms. The condition of two patients improved, and the condition of the other two stabilized.

Journal

NeurosurgeryOxford University Press

Published: Feb 1, 1999

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