Subaxial Cervical Lateral Mass Screw and Rod Fixation: Surgical Experience and Outcome Analysis

Subaxial cervical spine injuries (C3-C7) are common and often require stabilization due to their proximity to vital neurovascular structures. Posterior cervical spine surgery now commonly uses a lateral mass screw and rod fixation because of its biomechanical stability and versatility. This study aims to evaluate the long-term outcome and complications of this technique in tackling subaxial cervical spine pathologies.

A 3-year prospective observational study conducted at our hospital on 50 adult patients with subaxial cervical spine instability was carried out. The parameters recorded included preoperative, intraoperative, and postoperative information, and results obtained regarding fusion and hardware placement were assessed at 3 and 6 months post surgery. The Frankel grading system was used for neurologic assessment; the radiologic outcomes were fusion rates and placement of the hardware.

The mean age of the patients was 47 years (68% of males), and a majority of cases (56%) were from trauma. At 6 months, 62% of the patients showed improvement in neurological condition - 20% in fully recovered (Grade E) condition. The overall fusion and success rates of hardware position were 88% and 96%, respectively. The complications included 4% with superficial infection and 6% transient radiculopathy, which were rare. Misplacement of screws occurred in 2%, and all caused minor neurological deficiencies.

Our study has supported lateral mass screw and rod fixation as an effective and reliable technique of stabilization of the subaxial cervical spine with substantial neurological recovery and a very low complication rate.