scholarly journals Cervical lateral mass screw fixation without fluoroscopic control: analysis of risk factors for complications associated with screw insertion

2012 ◽  
Vol 132 (7) ◽  
pp. 947-953 ◽  
Author(s):  
Shinichi Inoue ◽  
Tokuhide Moriyama ◽  
Toshiya Tachibana ◽  
Fumiaki Okada ◽  
Keishi Maruo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Screw Fixation ◽  
Control Analysis ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Screw Insertion ◽  
Fluoroscopic Control

Risk factors for intraoperative lateral mass fracture of lateral mass screw fixation in the subaxial cervical spine

2014 ◽  
Vol 20 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Shinichi Inoue ◽  
Tokuhide Moriyama ◽  
Toshiya Tachibana ◽  
Fumiaki Okada ◽  
Keishi Maruo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Screw Fixation ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Screw Insertion ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
Lateral Mass Fracture ◽  
Destructive Spondyloarthropathy

ObjectAlthough lateral mass screw fixation for the cervical spine is a safe technique, lateral mass fracture during screw fixation is occasionally encountered intraoperatively. This event is regarded as a minor complication; however, it poses difficulties in management that may affect fixation stability and clinical outcome. The purpose of this study is to determine the incidence and etiology of lateral mass fractures during cervical lateral mass screw fixation.MethodsA retrospective clinical review of patient records was performed in 117 consecutive patients (mean age 57 years, range 15–86 years) who underwent lateral mass screw fixation using a modified Magerl method from 1997 to 2010 at a single institution. A total of 555 lateral masses were included in this study. The outer diameters of the screws were 3.5 or 4.0 mm. In the retrospective clinical analysis, the incidence of intraoperative lateral mass fractures was reviewed. Potential risk factors for this complication were assessed using multivariate analysis.ResultsThe incidence of lateral mass fractures during cervical lateral mass screw fixation was 4.7% (26 lateral masses) among all cases. Among the disorders, the incidence was highest in patients with destructive spondyloarthropathy (DSA) (18.8%, 12 lateral masses). There was no significant difference with respect to lateral mass fracture between the use of 4.0-mm screws (5.6%) and 3.5-mm screws (3.6%). Independent risk factors identified by logistic regression were DSA (OR 7.89, p < 0.001) and screw insertion in the C-6 lateral masses (OR 2.80, p = 0.018).ConclusionsThe overall incidence of lateral mass fracture during cervical lateral mass screw fixation was 4.7%. Destructive spondyloarthropathy as an underlying cause of morbidity and screw placement in the C-6 lateral mass were identified as independent risk factors. Use of a 4.0-mm screw in patients with DSA may be a principal risk factor for this complication.

C2 Nerve Root Transection During C1 Lateral Mass Screw Fixation

Neurosurgery ◽  
2014 ◽  
Vol 74 (5) ◽  
pp. 475-481 ◽  
Author(s):  
Michael C. Dewan ◽  
Saniya S. Godil ◽  
Stephen K. Mendenhall ◽  
Clinton J. Devin ◽  
Matthew J. McGirt
Keyword(s):  
Nerve Root ◽  
Screw Fixation ◽  
Neck Disability Index ◽  
Occipital Neuralgia ◽  
Lateral Mass ◽  
Negative Consequences ◽  
Lateral Mass Screw ◽  
Patient Reported ◽  
C2 Nerve Root ◽  
C1 Lateral Mass Screw

Abstract BACKGROUND: Sectioning of the C2 nerve root allows for direct visualization of the C1-2 joint and may facilitate arthrodesis. OBJECTIVE: To determine the clinical and functional consequences of C2 nerve root sectioning during placement of C1 lateral mass screws. METHODS: All patients undergoing C1 lateral mass screw fixation were included in this prospective study. A standard questionnaire was used to determine the severity of occipital numbness/pain and its effect on quality of life (QOL). Domains of the neck disability index were used to assess the disability related to C2 symptoms. RESULTS: A total of 28 patients were included (C2 transection, 8; C2 preservation, 20). A trend of decreased blood loss and length of surgery was observed in the C2 transection cohort. Occipital numbness was reported by 4 (50.0%) patients after C2 transection. Occipital neuralgia was reported by 7 (35.0%) patients with C2 preservation. None of the patients with numbness after C2 transection reported being “bothered” by it. All patients with occipital neuralgia after C2 sparing reported being “bothered” by it, and 57.1% reported a moderate to severe effect on QOL. The use of medication was reported by 5 (71.4%) patients with neuralgia vs none with numbness. Mean disability was significantly higher with neuralgia vs numbness (P = .016). CONCLUSION: C2 nerve root transection is associated with increased occipital numbness but this has no effect on patient-reported outcomes and QOL. C2 nerve root preservation can be associated with occipital neuralgia, which has a negative impact on patient disability and QOL. C2 nerve root transection has no negative consequences during C1-2 stabilization.

The Feasibility of Microscope-Assisted “Free-Hand” C1 Lateral Mass Screw Insertion Without Fluoroscopy

Spine ◽  
2008 ◽  
Vol 33 (9) ◽  
pp. 1042-1049 ◽  
Author(s):  
Gabriel Liu ◽  
Jacob M. Buchowski ◽  
Hongxing Shen ◽  
Jin Sup Yeom ◽  
K Daniel Riew
Keyword(s):  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Screw Insertion ◽  
C1 Lateral Mass Screw

C1 Lateral Mass Screw Insertion With Protection of C1-C2 Venous Sinus

Spine ◽  
2010 ◽  
Vol 35 (21) ◽  
pp. E1133-E1136 ◽  
Author(s):  
Jie Pan ◽  
Lijun Li ◽  
Lie Qian ◽  
Jun Tan ◽  
Guixin Sun ◽  
...  
Keyword(s):  
Venous Sinus ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Screw Insertion ◽  
C1 Lateral Mass Screw

scholarly journals Posterior Subaxial Cervical Spine Screw Fixation: A Review of Techniques

2018 ◽  
Vol 8 (7) ◽  
pp. 751-760 ◽  
Author(s):  
Andrei Fernandes Joaquim ◽  
Marcelo Luis Mudo ◽  
Lee A. Tan ◽  
K. Daniel Riew
Keyword(s):  
Cervical Spine ◽  
Literature Review ◽  
Screw Fixation ◽  
Surgical Techniques ◽  
Pedicle Screw Fixation ◽  
Lateral Mass ◽  
Modified Technique ◽  
Screw Insertion ◽  
Subaxial Cervical Spine ◽  
Fixation Techniques

Study Design: A narrative literature review. Objectives: To review the surgical techniques of posterior screw fixation in the subaxial cervical spine. Methods: A broad literature review on the most common screw fixation techniques including lateral mass, pedicle, intralaminar and transfacet screws was performed on PubMed. The techniques and surgical nuances are summarized. Results: The following techniques were described in detail and presented with illustrative figures, including (1) lateral mass screw insertion: by Roy-Camille, Louis, Magerl, Anderson, An, Riew techniques and also a modified technique for C7 lateral mass fixation; (2) pedicle screw fixation technique as described by Abumi and also a freehand technique description; (3) intralaminar screw fixation; and finally, (4) transfacet screw fixation, as described by Takayasu, DalCanto, Klekamp, and Miyanji. Conclusions: Many different techniques of subaxial screw fixation were described and are available. To know the nuances of each one allows surgeons to choose the best option for each patient, improving the success of the fixation and decrease complications.

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