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Techniques and pitfalls of cervical lateral mass plate fixation
A J Muffoletto1, A G Hadjipavlou, R E Jensen
1Department of Orthopedics and Rehabilitation, University of Texas Medical Branch, Galveston, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|November 18, 2000
Summary
Subaxial lateral mass fixation is effective, with 89% fusion rates. Optimal drilling techniques and monitoring reduce screw misplacement and complications, ensuring patient safety and successful outcomes.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Spinal Surgery
Background:
- Subaxial lateral mass fixation is a common surgical procedure for stabilizing the cervical spine.
- Assessing screw placement accuracy and fusion rates is crucial for surgical success.
Purpose of the Study:
- To evaluate the accuracy of screw placement and fusion rates in subaxial lateral mass fixation.
- To identify factors associated with optimal screw placement and successful fusion.
Main Methods:
- Retrospective review of 35 patients undergoing subaxial lateral mass fixation.
- Analysis of postoperative computed tomography (CT) scans for screw trajectory and impingement.
- Assessment of fusion rates at 2- to 3.5-year follow-up.
Main Results:
- 31% of screws (45/146) had suboptimal trajectory on CT scans.
- Only 2 screws minimally impinged the foramen transversarium without adverse effects.
- An overall fusion rate of 89% was achieved.
Conclusions:
- Optimal drilling technique and trajectory are associated with improved screw placement and reduced complications.
- Intraoperative somatosensory evoked potential monitoring aids in achieving good screw placement.
- Bone grafting is linked to higher fusion rates in subaxial lateral mass fixation.