Utility of modified transarticular screw in the middle and lower cervical spine as intermediate fixation in posterior long fusion surgery

Journal of Neurosurgery. Spine
Hiroshi MiyamotoKoki Uno

Abstract

The use of a pedicle screw (PS) in the cervical spine ensures strong fixation. However, 6.7-29% of such screws appear to be malpositioned using manual insertion techniques, especially at C-3 to C-6 where the pedicle diameter is smaller, potentially causing catastrophic complications such as vertebral artery (VA) and spinal cord or nerve root injuries. To optimize safety, the authors use a new technique: cephalad and/or caudad ends at C-2 and C-7/T-1, respectively, are fixed with PSs, and intermediate points around C3-6 are fixed using a modified transarticular screw technique that captures 3 dorsal cortices and preserves the ventral cortex of the facet in posterior long fusion surgery involving occipitospinal fixation. The purpose of the present study was to demonstrate this technique and evaluate the clinical and radiological outcomes. Thirty-nine patients, 8 men and 31 women, with a mean age of 61.7 +/- 11.0 years at surgery, were included in the study. Twenty-eight occipitospinal fusions and 11 posterior long fusions were performed. Patients were divided into 2 groups: a rheumatoid arthritis (RA) group consisting of 26 patients and a non-RA group of 13 patients including 7 with athetoid cerebral palsy. Clinical outcomes were...Continue Reading

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Citations

Feb 15, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yang DuanAn-Min Jin
Mar 3, 2012·World Neurosurgery·Faiz AhmadMichael Y Wang
Nov 26, 2010·Journal of Orthopaedic Surgery and Research·Raj BahadurSujit K Tripathy
Jan 15, 2013·World Neurosurgery·Kyongsong KimAkira Teramoto
Nov 5, 2015·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jie TongQingan Zhu

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