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C2 nerve root transection during C1 lateral mass screw fixation: does it affect functionality and quality of life?
Michael C Dewan1, Saniya S Godil, Stephen K Mendenhall
1*Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee; ‡Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina; §Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
C2 nerve root transection during C1-2 stabilization causes numbness but does not affect patient outcomes. Preserving the C2 nerve root may lead to occipital neuralgia, negatively impacting quality of life.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedic Surgery
Background:
- C2 nerve root sectioning aids C1-2 joint visualization for arthrodesis.
- Understanding the consequences of C2 nerve root manipulation is crucial for surgical decision-making.
Purpose of the Study:
- To evaluate the clinical and functional outcomes of C2 nerve root sectioning versus preservation during C1 lateral mass screw placement.
Main Methods:
- Prospective study of patients undergoing C1 lateral mass screw fixation.
- Utilized questionnaires to assess occipital numbness/pain, quality of life, and neck disability.
Main Results:
- C2 transection group (8 patients) showed trends toward reduced blood loss and surgery length.
- Occipital numbness occurred in 50% of C2 transection patients, with no reported bother.
- Occipital neuralgia occurred in 35% of C2 preservation patients, significantly impacting quality of life and disability.
Conclusions:
- C2 nerve root transection results in numbness with no negative impact on patient-reported outcomes or quality of life.
- C2 nerve root preservation may lead to occipital neuralgia, causing significant disability and reduced quality of life.
- C2 nerve root transection is a safe option with no adverse consequences in C1-2 stabilization procedures.
