Background
Many techniques for cervical stabilization have been evaluated in the management of cervical disorders. Anterior fixation generally has a limited role and is used for anterior column disorders or in addition to posterior fixation in certain situations; however, several complications have been associated with this technique. Posterior fixation and fusion may be the approach of choice in cases that require multilevel decompression, particularly if extension to upper cervical, occiput, or upper thoracic is required.
Patients and methods
A prospective study of 200 lateral mass screws which have been placed in 25 (eight women and 17 men) patients aged 20–76 years. All cases were performed with a polyaxial screw–rod system. Harms technique was used in the upper cervical spine, and Magerl technique in the subaxial spine. Screw location was assessed by intraoperative fluoroscopy and was confirmed postoperatively using plain radiograph and computed tomography (in some cases).
Results
No patients experienced iatrogenic neural or vascular injury. Four patients experienced superficial wound infection. Three patients had pain around the shoulder of C5 distribution which subsided over time. No patients developed screw pullouts or symptomatic adjacent segment disease within the period of follow-up. The mean follow-up period was 1.5 years.
Conclusion
Posterior cervical fixation with a screw–rod system is a safe and efficient method of treatment that can be used for a variety of cervical spine pathologies.