Posterior Cervical Lateral Mass Screw Fixation and Fusion to Treat Pseudarthrosis of Anterior Cervical Fusion

Study Design: Retrospective clinical cohort study. Objective: To determine the efficacy of posterior lateral mass screw/rod fixation and fusion for the treatment of symptomatic pseudarthrosis of anterior cervical fusion. Summary of Background Data: Both anterior revision and posterior repair of cervical pseudarthrosis have been reported. To date, there is still debate in the literature as how the patient with symptomatic cervical pseudarthrosis should be addressed. Methods: Thirty-eight consecutive patients with symptomatic anterior cervical pseudarthrosis were treated with posterior lateral mass screw/rod fixation and fusion. The average follow-up was 28 months (24 to 60 mo) and patients were assessed with clinical examination, questionnaires, flexion-extension lateral radiographs, and/or computed tomography scans. The clinical results were classified as excellent, good, fair, or poor, according to Zdeblick criteria. Results: All patients achieved a solid radiographic fusion at the final follow-up. The result was excellent in 10 patients, good in 22, fair in 6, and poor in none. Conclusions: Patients with symptomatic cervical pseudarthrosis that develops after anterior cervical discectomy and fusion may be managed successfully with posterior lateral mass screw fixation and fusion.