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Occipitocervical Fixation: A Single Surgeon's Experience With 120 Patients
Eduardo Martinez-Del-Campo1, Jay D Turner, Samuel Kalb
1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Neurosurgery
|July 19, 2016
Summary
Occipitocervical fixation offers a durable solution for instability, with 89.1% fusion rates and significant neurological improvement in 91% of affected patients. This surgical approach demonstrates acceptable morbidity for managing complex spinal conditions.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Occipitocervical junction instability poses significant risks, including neurological injury and mortality.
- Open surgical fixation is a primary method for stabilization, yet long-term data are scarce.
- Understanding causes, indications, and outcomes is crucial for effective patient management.
Purpose of the Study:
- To review the etiologies of occipitocervical instability.
- To delineate the indications for surgical intervention.
- To evaluate the long-term surgical outcomes of occipitocervical fixation.
Main Methods:
- Retrospective review of 120 consecutive patients undergoing posterior occipitocervical fixation.
- Analysis of patient demographics, pathology, surgical techniques, and outcomes.
- Reporting of clinical and radiographic results with a mean follow-up of 35.1 months.
Main Results:
- Trauma was the leading cause of instability (47%).
- Screw/rod constructs were used in 75% of patients; 89.1% achieved fusion.
- 83% of patients with preoperative deficits improved neurologically post-surgery.
- Overall complication rate was 10%, with low rates of severe complications.
Conclusions:
- Occipitocervical fixation is a reliable and durable treatment for occipitocervical instability.
- The procedure offers acceptable morbidity and significant potential for neurological recovery.
- Long-term data support its use in managing complex craniovertebral junction pathologies.
