[A new plate for dorsal occipito-cervical fusion. Design, surgical technique, initial clinical results]

A survey of actually practiced methods for cranio-cervical fusion is presented, followed by the description of a new osteosynthesis-plate to solidly fuse this region. The new plate offers a number of advantages when compared with competing procedures. It is rigidly fixed to the occipital bone by five screws, sublaminar wireloops bond the vertebrae to be fused to both branches of the U-shaped plate where the individual loops are positioned into obliquely ascending slots. This safely prevents migration and disengagement resulting in a high initial horizontal and vertical stability allowing for a postoperative care without external support. During the procedure tightening of the wire loops may succeed on reposition of the deformity. The plate exists in two lengths allowing fusion of C0-C2 or more segments of the cervical spine. The typical indication is instability of C0-C2 in rheumatoid arthritis or tumoral lesions of the area. Clinical experience in 7 patients suffering from rheumatoid arthritis (follow-up: 6-31 months) is very positive, fusion has occurred in all cases.