Study Design:
We performed a retrospective analysis of 20 patients with multilevel cervical disease treated with posterior fusion and lateral mass plating with a new fixation system.
Objectives:
We vvished to determine the applicability, safety and clinical efficacy of an instrumentation system applied as a cervical lateral mass plate in the treatment of complex spinal disorders.
Summary of Background Data:
Cervical disorders involving three or more levels, especially if the posterior elements are deficient, present a difficult reconstruction problem. Segmental fixation with lateral mass plating pro-vides an alternative method to traditional techniques and may be applicable in situations that would othervvise re-quire a halo postoperatively.
Methods:
Twenty consecutive patients with a minimum 12 month follow-up treated by a single surgeon un-derwent cervical reconstructive surgery involving three or more levels. Ali patients had a posterior fusion and fixa-tion with a device applied to the lateral masses of the cervical vertebrae. Patients were revievved clinically and ra-diographically to determine the efficacy and safety of this method of fixation.
Results:
Of the 18 patients with full clinical and radiographic follow-up at a minimum of 12 months, 16 (89%) stated they were clinically improved, 1 (5.5%) stated he was the same, and 1 (5.5%) stated he was worse than before surgery at the most recent follow-up. Sagittal alignment was restored to vvithin 5 degrees of the preopera-tive lordosis in active extension by both the modified. Cobb method and the Gore method. No patient had radiographic nonunion. One patient had a sensory radiculopathy associated with an overpenetrated lateral mass screw that partially resolved after hardware removal. One patient had assymptomatic loosening of a C-7 lateral mass sere w.
Conclusions:
Segmental posterior fixation with lateral mass plating provides more rigid immobilization than traditional techniques, allows restoration and maintenance of spinal alignment, and obviates the need for halo immobilization with a low incidence of neurovascular injury.
Keywords: Posterior, Cervical, Arthodesis, Lateral Mass, Plating.