Evaluating laminar and lateral mass screw techniques in cervical injury management: A case series

The cervical spine is a dynamic structure that protects adjacent nervous innervation and maintains the range of motion (ROM) of the head and neck. Fractures in this area can lead to high mortality and morbidity, with bone fractures accounting for 56 % of cervical spinal cord injuries. This case series presents a series of cervical pathologies treated with posterior decompression and stabilization using laminar and lateral mass screw fixation.

This research is a case series of four patients treated with laminar and lateral mass screw technique. All patients received a surgical procedure, including posterior compression and stabilization, which included the use of a laminar and lateral mass screw. We followed the patient for 12 months. During follow up, outcome measures consisting of VAS, range of motion, neurological status, ODI Score, SF-12 Score and any complications related to the surgical procedure was recorded and calculated every 3 months.

This series examines four distinct cases. The initial case pertained to a female patient, aged 72, who exhibited tetraparesis resulting from a burst fracture occurring in the C3-C5 vertebrae. The underlying etiology of this pathology is considered to be mineral bone disease associated with thyroid hormone imbalance due to thyroid cancer. The second instance was a 14-year-old child experiencing neck pain due to spondylitis tuberculosis in the C1-C2 region, accompanied by a retropharyngeal abscess and occipitocervical dissociation (OCD) with basilar invagination. The third example pertained to a patient who is 9 years old and presented with weakness in all extremities due to C1 fracture-dislocation. The fourth case was a 14-year-old patient who experienced a fall from a bunk bed. This patient was diagnosed with Traumatic Atlantoaxial dislocation with odontoid fracture Type II. All patients showed improved cervical curvature and range of motion with the advantages of reduction of intraoperative haemorrhage, as well as a decrease in postoperative rehabilitation duration. Overall, the data shows a general trend of improvement in VAS and ODI scores over time, with SF-12 scores stabilizing or slightly decreasing by 12 months post-operation.

The use of a lateral mass screw for subaxial cervical injuries can be employed to manage cervical spine pathologies like fractures and infections, including spondylitis TB. However, more research is required to evaluate the long-term complications and success rates of this technique.