Evaluation of spinal laminar fixation by a new, flexible stainless steel cable (Sof'wire): early results

Segmental spinal stabilizations have been carried out in 72 patients (age, 5-79 yr) during the first 2 years of the availability of a new, flexible, multistranded stainless steel cable (Sof'wire, Hillway Surgical Ltd., London). A total of 519 sublaminar and occipital cables have been passed at 280 levels to fix an occipitocervical loop (36 patients) or contoured rectangle (14 patients). In 15 other patients, a Gallie fusion was combined with a C1-C2 lateral mass screw fixation; a cable-bone construct was used in five patients. Clinical and radiological follow-up at 1, 3, 6 (61 patients), 12 (48 patients), and 18 months (29 patients) and at 2 years (8 patients) has demonstrated no cable breakage or loosening. One postoperative death was due to inadequate transoral decompression before posterior fixation, and, in the 32 patients who underwent spinal monitoring, there were no major changes noted during surgery and no new postoperative neurological symptoms or signs. These preliminary observations are encouraging and merit further multicenter investigations.