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Published on: September 16, 2022
Complications of posterior cervical plating
J G Heller1, D H Silcox, C E Sutterlin
1Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA.
Spine
|November 15, 1995
Summary
Posterior cervical plating using lateral mass screws has a lower complication rate than predicted by cadaver studies. This clinical evaluation identified risks such as spinal cord injury and adjacent segment degeneration.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Limited clinical data exists on complications associated with posterior cervical plating.
- Previous studies primarily focused on cadaveric analysis of risks.
Purpose of the Study:
- To quantify clinical complications of posterior cervical plating with lateral mass screw fixation.
- To compare observed complications with theoretical risks from cadaver studies.
- To identify unanticipated complications.
Main Methods:
- Retrospective review of 78 consecutive patients undergoing posterior cervical lateral mass plating.
- Analysis of complications per screw inserted and per case performed.
- Average follow-up of 2 years.
Main Results:
- Low complication rates per screw: nerve root injury (0.6%), facet violation (0.2%), vertebral artery injury (0%), broken screw (0.3%), screw avulsion (0.2%), screw loosening (1.1%).
- Complications per case: spinal cord injury (2.6%), iatrogenic foraminal stenosis (2.6%), broken plate (1.3%), lost reduction (2.6%), adjacent segment degeneration (3.8%), infection (1.3%), pseudoarthrosis (1.4%).
Conclusions:
- Clinical complication rates for lateral mass screw insertion are lower than predicted by in vitro studies.
- This study identified complications not previously predicted in laboratory settings.
