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Posterior instrumentation for occipitocervical fusion
George Sapkas1, Stamatios A Papadakis, Dimitrios Segkos
1A' Department of Orthopaedics, Medical School of Athens University, "Attikon" University Hospital, Haidari, Greece.
The Open Orthopaedics Journal
|July 21, 2011
Summary
Posterior occipitocervical fusion using screw-rod or hook-and-screw-rod instrumentation effectively treats craniocervical instability. Both methods demonstrate safety and efficacy, with high fusion rates and significant patient improvement.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Craniocervical spine instability presents complex management challenges.
- Posterior occipitocervical instrumentation and fusion are established surgical techniques.
Purpose of the Study:
- To evaluate the safety and efficacy of posterior occipitocervical instrumentation and fusion for craniocervical instability.
- To compare screw-rod versus hook-and-screw-rod instrumentation outcomes.
- To assess the impact of laminectomy on surgical outcomes.
Main Methods:
- A consecutive series of 29 patients with craniocervical instability underwent posterior occipitocervical instrumentation and fusion.
- Patients were divided into screw-rod (Group A) and hook-and-screw-rod (Group B) groups.
- Clinical and radiographic parameters including neurological status, pain relief, and fusion were assessed postoperatively and during follow-up.
Main Results:
- Fusion was achieved in 28 of 29 patients, with one infection as the sole surgery-related complication.
- The majority of patients experienced neurological improvement and significant pain relief.
- No statistical difference in outcomes was found between screw-rod and hook-and-screw-rod instrumentation; laminectomy did not significantly influence results.
Conclusions:
- Both screw-rod and hook-and-screw-rod occipitocervical fusion techniques are safe and effective for treating craniocervical instability.
- These methods lead to acceptable reduction and maintenance of spinal alignment.
- Patient outcomes are generally favorable with low complication rates.
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