Comparison between C1-2 Fixation with and without Supplemental Posterior Wiring

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Fusion Techniques

Background:

• Cervical spine fusion, particularly at the C1-2 level, is a common procedure.
• Screw-rod constructs (SRC) are widely used for C1-2 fixation.
• The role of supplemental wiring in SRC for C1-2 fixation remains debated.

Purpose of the Study:

• To compare the outcomes of C1-2 fixation using SRC with wiring versus SRC without wiring.
• To evaluate differences in fusion rates, implant failure, reoperation, donor-site morbidity, and complications.

Main Methods:

• Retrospective analysis of 26 patients undergoing C1-2 fixation between 2004 and 2012.
• Two groups: 13 patients with SRC and wiring, 13 patients with SRC without wiring.
• Fusion assessed by dynamic X-rays and CT scans; pseudoarthrosis confirmed during reoperation.

Main Results:

• Fusion rates were 92% (without wiring) and 100% (with wiring).
• Implant failure and reoperation rates were 8% and 8% (without wiring), versus 0% and 0% (with wiring).
• No donor-site morbidity or complications were reported in either group (0%).

Conclusions:

• Supplementing SRC with wiring may potentially increase fusion rates for C1-2 fixation.
• No statistically significant differences were found between the two groups in the parameters examined.
• Despite a small sample size, outcomes were comparable between SRC with and without wiring at an average 2-year follow-up.