Posterior Cervical Arthrodesis and Stabilization: An Early Report Using a Novel Lateral Mass Screw and Rod Technique

Posterior Cervical Arthrodesis and Stabilization: An Early Report Using a Novel Lateral Mass... AbstractOBJECTIVEPosterior cervical arthrodesis and stabilization with lateral mass plates is a biomechanically sound construct in multiple planes of motion. It is reproducible and especially useful when the posterior elements are missing or fractured. Unfortunately, it is difficult to use in patients with severe degenerative spondylosis because the plate is malleable only in the sagittal plane and the screw positions are dictated by the plate's entry holes.METHODSA novel system of lateral mass screws that can be positioned before placement of a lateral construct was used in nine patients. Their outcomes as well as the technical applications of this system were reviewed.RESULTSA total of 52 screws were placed in nine patients who underwent posterior cervical arthrodesis with the Cervifix system (Synthes USA, Paoli, PA). Diagnoses included trauma in four patients, degenerative spondylosis in three, and tumor in two. Rods were molded individually according to the patient's anatomy. Compression, distraction, and lateral rotation, if indicated, were performed. Follow-up averaged 36 weeks. Lateral and anteroposterior radiographs, obtained at progressive intervals, revealed excellent fixation and screw purchase without pull-out. There were no cases of spinal cord, nerve root, or vertebral artery injury.CONCLUSIONThe Cervifix system accommodates variation in anatomic size and spacing of the lateral masses, potentiating precise screw placement. The rods can be molded in multiple planes, and selective application of compressive, distractive, or lateral rotatory forces is allowed. The system is very straightforward and simple to use, and we have had good success without pseudarthrosis or complications from screw placement in our series. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Posterior Cervical Arthrodesis and Stabilization: An Early Report Using a Novel Lateral Mass Screw and Rod Technique

Posterior Cervical Arthrodesis and Stabilization: An Early Report Using a Novel Lateral Mass Screw and Rod Technique

Posterior Cervical Arthrodesis and Stabilization: An Early Report Using a Novel Lateral Mass Screw and Rod Technique Michael A. Horgan, M .D., Jordi X. Kellogg, M .D ., Randall M. Chesnut, M.D. Department of Neurosurgery, Oregon Health Sciences University, Portland, Oregon OBJECTIVE: P o s t e r i o r c e r v i c a l a r t h r o d e s i s a n d s t a b i l i z a t i o n w it h la t e r a l m a s s p la t e s is a b i o m e c h a n i c a l l y s o u n d construct in m u l t i p l e p l a n e s o f m o t i o n . It is r e p r o d u c i b l e a n d e s p e c i a l l y u se fu l w h e n t h e p o s t e r i o r e l e m e n t s a r e missing or f r a c t u r e d . U n f o r t u n a t e l y , it is d if f ic u lt to u se in p a t ie n t s w it h s e v e r e d e g e n e r a t i v e s p o n d y l o s i s b e c a u s e the plate is m a l l e a b l e o n l y in t h e s a g it ta l p l a n e a n d th e s c r e w p o s it io n s a r e d i c t a t e d b y th e p la t e 's e n t r y h o le s . M ETH O D S: A n o v e l s y s t e m o f l a t e r a l m a s s s c r e w s th at c a n be p o s it io n e d b e f o r e p l a c e m e n t o f a la t e r a l c o n s t r u c t w a s used in n in e p a t ie n t s . T h e i r o u t c o m e s a s w e l l a s th e t e c h n i c a l a p p l i c a t i o n s o f th is s y s t e m w e r e r e v i e w e d . RESULTS: A to tal o f 5 2 s c r e w s w e r e p l a c e d in n i n e p a t ie n t s w h o u n d e r w e n t p o s t e r i o r c e r v i c a l a r t h r o d e s i s w i t h th e Cervifix s y s t e m ( S y n t h e s U S A , P a o l i , P A ) . D i a g n o s e s i n c l u d e d t r a u m a in f o u r p a t ie n t s , d e g e n e r a t i v e s p o n d y l o s i s in three, a n d t u m o r in t w o . R o d s w e r e m o l d e d i n d i v i d u a l l y a c c o r d i n g to th e p a t ie n t 's a n a t o m y . C o m p r e s s i o n , distraction, a n d l a t e r a l r o t a t i o n , if i n d i c a t e d , w e r e p e r f o r m e d . F o l l...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199906000-00060
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVEPosterior cervical arthrodesis and stabilization with lateral mass plates is a biomechanically sound construct in multiple planes of motion. It is reproducible and especially useful when the posterior elements are missing or fractured. Unfortunately, it is difficult to use in patients with severe degenerative spondylosis because the plate is malleable only in the sagittal plane and the screw positions are dictated by the plate's entry holes.METHODSA novel system of lateral mass screws that can be positioned before placement of a lateral construct was used in nine patients. Their outcomes as well as the technical applications of this system were reviewed.RESULTSA total of 52 screws were placed in nine patients who underwent posterior cervical arthrodesis with the Cervifix system (Synthes USA, Paoli, PA). Diagnoses included trauma in four patients, degenerative spondylosis in three, and tumor in two. Rods were molded individually according to the patient's anatomy. Compression, distraction, and lateral rotation, if indicated, were performed. Follow-up averaged 36 weeks. Lateral and anteroposterior radiographs, obtained at progressive intervals, revealed excellent fixation and screw purchase without pull-out. There were no cases of spinal cord, nerve root, or vertebral artery injury.CONCLUSIONThe Cervifix system accommodates variation in anatomic size and spacing of the lateral masses, potentiating precise screw placement. The rods can be molded in multiple planes, and selective application of compressive, distractive, or lateral rotatory forces is allowed. The system is very straightforward and simple to use, and we have had good success without pseudarthrosis or complications from screw placement in our series.

Journal

NeurosurgeryOxford University Press

Published: Jun 1, 1999

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