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POSTERIOR CERVICAL ARTHRODESIS WITH LATERAL MASS PLATING FOR MULTILEVEL CERVICAL DISEASE

  • M.L. SWANK
  • B.E. DIALS
  • C.E. SUTTERLIN

J Turk Spinal Surg 1995;6(1):25-31

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.