Lower cervical spine injury treated with lateral mass plates and pedicle screws through posterior approach

Objective: To treat injury of the lower cervical spine C6 to C7 with cervical lateral mass plates and T1 pedicle screws through posterior approach. Methods: The data of 8 patients with lower cervical spine C6 or C7 injury （6 patients with fracture and dislocation in C6 and C7 and 2 with fracture in C7） were analyzed retrospectively in this study. For the preoperative American Spinal Injury Association （ASIA） classification, Grade C was found in 3 cases and Grade D in 5 cases. Screws were placed on the lateral masses and the first thoracic pedicle with Margerl technique. Lamina or facet bone allografting was used to achieve a long-term stability. Results: All the 8 patients were followed up for 5-37 months （mean: 15 months）. No operative death occurred. There were no examples of aggravation of spinal cord injury or vertebral artery injury, cerebrospinal fluid leak, nerve roots injury, screw malposition or back-out, loose of alignment or implant failure. Clinical symptoms and ASIA classification were improved in all the patients. Postoperative MRI scanning confirmed the satisfactory screw placement in all the cases. Conclusions: Lateral mass plates and pedicle screws through posterior approach are safe and beneficial for patients with lower cervical spine C6 or C7 injury.