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Posterior cervical lateral mass fixation for the management of insufficient anterior stabilization
Leszek M Sagan1, Marek B Lickendorf
1Department of Neurosurgery and Pediatric Neurosurgery Pomeranian Medical University ul. Unii Lubelskiej 1, 71-252 Szczecin.
Purpose:
There are clinical situations when anterior fixation alone is not sufficient to adequately stabilize the cervical spine at the level of operation. In vitro biomechanical studies revealed the substantial role of posterior stabilization in such situations. However, no clinical studies of this problem have been published. The usefulness of posterior cervical lateral mass fixation when anterior stabilization failed to offer sufficient spine stability was assessed in the present study.
Material And Methods:
We enrolled 15 patients who underwent additional posterior fixation due to destabilization of the anterior one. There were five patients with rheumatoid arthritis, six with cervical discopathy, three with cervical trauma, and one with spine tumor. Improvement after posterior fixation was noted in all but one patient.
Results:
Posterior cervical lateral mass fixation significantly improved cervical spine stability in cases with insufficiency of anterior stabilization. Further investigations on criteria helpful to predict insufficiency of anterior stabilization in cases of multisegmental cervical spine disease are needed.