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Mechanical implant failure in posterior cervical spine fusion
Takeshi Okamoto1, Masashi Neo, Shunsuke Fujibayashi
1Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. okaken@kuhp.kyoto-u.ac.jp
Purpose:
The aim of this study was to determine whether the recent refinement and downsizing of the implants for posterior cervical fusion increase the occurrence of implant failure.
Methods:
One hundred forty-two consecutive cases of cervical fusion, using either cannulated Magerl screws or a multiaxial pedicle screw-rod system, were reviewed retrospectively after an average follow-up period of more than 3 years, and the rate and characteristics of the failure of these implants were evaluated.
Results:
Implant failure occurred in six (4.2%) patients: five with rheumatoid arthritis and one with athetoid cerebral palsy. Occipital plate fracture occurred in two patients, Magerl screw breakage in one patient, cervical pedicle screw fracture in two patients, and disassembly of the pedicle screw and rod in two patients (one with an occipital plate fracture). There was no rod fracture. The implant failures were asymptomatic, except in one patient. Disassembly of the pedicle screw and rod was observed immediately after another surgical procedure under general anesthesia in two patients.
Conclusions:
The failure rate of 4.2% was similar to the rates reported in the literature for posterior lumbar spinal fusion, confirming the reliability of the recent cervical screw-rod system.