Multiple Rod Construct for Occipito-Cervical Fusion: Overcoming Challenges With Enabling Technologies

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Fusion Techniques

Background:

• Occipito-cervical fusion (OCF) is crucial for cranio-vertebral junction (CVJ) anomalies.
• Rigid internal fixation is necessary for stability, but implant failure remains a concern, especially in compromised patients.
• Existing methods may not always provide sufficient biomechanical stability for long-term fusion success.

Purpose of the Study:

• To describe and evaluate a novel method using multiple rod constructs for OCF.
• To assess the biomechanical stability, fusion rates, and clinical outcomes of this technique.
• To investigate the prevention of implant failure in OCF procedures.

Main Methods:

• Retrospective observational study of 10 patients undergoing OCF with navigation-guided cervical pedicle screw fixation and multiple rod constructs.
• Minimum 12-month follow-up evaluating clinical parameters (VAS, NDI, Nurick, mJOA) and radiological parameters (O-C2 lordosis, C2-C7 lordosis, CCA).
• Fusion assessment via CT scan at 12 months post-operatively.

Main Results:

• All patients demonstrated significant improvement in clinical and radiological outcomes.
• Early mobilization on postoperative day 1 was possible in all patients.
• No implant failures were observed; CT scans confirmed bony trabeculae formation, indicating successful fusion.

Conclusions:

• Multiple rod constructs provide a biomechanically stable OCF solution, enhancing fusion rates and clinical outcomes.
• This technique facilitates early mobilization and reduces complications like implant failure, particularly in patients with challenging anatomy.
• The multi-anchorage approach across the cervical spine and occiput offers superior stability for CVJ stabilization.