Posterior Bilateral Intermuscular Approach for Upper Cervical Spine Injuries

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Anatomy

Background:

• Posterior upper cervical spine fixation is crucial for stabilizing injuries.
• Existing approaches may have limitations requiring novel techniques.

Purpose of the Study:

• To evaluate a novel intermuscular surgical approach for posterior upper cervical spine fixation.
• To assess the feasibility and outcomes of this approach in patients with upper cervical spine trauma.

Main Methods:

• Magnetic resonance imaging (MRI) was used to analyze anatomical landmarks in 23 volunteers.
• A bilateral intermuscular approach was performed on 12 patients with upper cervical spine injuries.
• Surgical time, blood loss, and visual analogue scale (VAS) scores were recorded.

Main Results:

• Anatomical measurements defined the surgical corridor.
• The average surgical time was 78.3 minutes with mean blood loss of 87.5 mL.
• Preoperative VAS scores (6.4) significantly decreased to 1.8 postoperatively.

Conclusions:

• The posterior bilateral intermuscular approach is a viable alternative for specific upper cervical spine injuries.
• This technique is suitable for Hangman's fractures (types I, II, Ia) and atlantoaxial subluxation.
• The approach offers effective pain reduction and stabilization for upper cervical trauma.