Posterior cervical arthrodesis and stabilization: An early report using a novel lateral mass screw and rod technique

被引:21
作者
Horgan, MA [1 ]
Kellogg, JX [1 ]
Chesnut, RM [1 ]
机构
[1] Oregon Hlth Sci Univ, Dept Neurosurg, Portland, OR 97201 USA
关键词
arthrodesis; cervical spine; lateral mass; plate; screw;
D O I
10.1097/00006123-199906000-00060
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: Posterior cervical arthrodesis and stabilization with lateral mass prates 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. METHODS: A 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. RESULTS: A 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, ii 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. CONCLUSION: The 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.
引用
收藏
页码:1267 / 1271
页数:5
相关论文
共 15 条
[1]   ANATOMIC CONSIDERATIONS FOR PLATE-SCREW FIXATION OF THE CERVICAL-SPINE [J].
AN, HS ;
GORDIN, R ;
RENNER, K .
SPINE, 1991, 16 (10) :S548-S551
[2]   POSTERIOR CERVICAL ARTHRODESIS WITH AO RECONSTRUCTION PLATES AND BONE-GRAFT [J].
ANDERSON, PA ;
HENLEY, MB ;
GRADY, MS ;
MONTESANO, PX ;
WINN, HR .
SPINE, 1991, 16 (03) :S72-S79
[3]   BIOMECHANICAL EVALUATION OF CERVICAL SPINAL STABILIZATION METHODS IN A HUMAN CADAVERIC MODEL [J].
COE, JD ;
WARDEN, KE ;
SUTTERLIN, CE ;
MCAFEE, PC .
SPINE, 1989, 14 (10) :1122-1131
[4]   POSTERIOR PLATES IN THE MANAGEMENT OF CERVICAL INSTABILITY - LONG-TERM RESULTS IN 44 PATIENTS [J].
FEHLINGS, MG ;
COOPER, PR ;
ERRICO, TJ .
JOURNAL OF NEUROSURGERY, 1994, 81 (03) :341-349
[5]   POSTERIOR PLATING OF THE CERVICAL-SPINE - A BIOMECHANICAL COMPARISON OF DIFFERENT POSTERIOR FUSION TECHNIQUES [J].
GILL, K ;
PASCHAL, S ;
CORIN, J ;
ASHMAN, R ;
BUCHOLZ, RW .
SPINE, 1988, 13 (07) :813-816
[6]   Posterior cervical arthrodesis and stabilization with a lateral mass plate - Clinical and computed tomographic evaluation of lateral mass screw placement and associated complications [J].
Graham, AW ;
Swank, ML ;
Kinard, RE ;
Lowery, GL ;
Dials, BE .
SPINE, 1996, 21 (03) :323-328
[7]   THE ROLE OF PLATE AND SCREW FIXATION IN OCCIPITOCERVICAL FUSION IN RHEUMATOID-ARTHRITIS [J].
GROB, D ;
DVORAK, J ;
PANJABI, MM ;
ANTINNES, JA .
SPINE, 1994, 19 (22) :2545-2551
[8]   COMPLICATIONS OF POSTERIOR CERVICAL PLATING [J].
HELLER, JG ;
SILCOX, DH ;
SUTTERLIN, CE .
SPINE, 1995, 20 (22) :2442-2448
[9]   ANATOMIC COMPARISON OF THE ROY-CAMILLE AND MAGERL TECHNIQUES FOR SCREW PLACEMENT IN THE LOWER CERVICAL-SPINE [J].
HELLER, JG ;
CARLSON, GD ;
ABITBOL, JJ ;
GARFIN, SR .
SPINE, 1991, 16 (10) :S552-S557
[10]   POSTERIOR STABILIZATION OF THE CERVICAL-SPINE WITH HOOK PLATES [J].
JEANNERET, B ;
MAGERL, F ;
WARD, EH ;
WARD, JC .
SPINE, 1991, 16 (03) :S56-S63