Clinical and Computed Tomographic Evaluation of Safety and Efficacy of Facet Screw Fixation in the Subaxial Cervical Spine

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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Radiographic and clinical assessment of a freehand lateral mass screw fixation technique: is it always safe in subaxial cervical spine?

The Spine Journal ◽

10.1016/j.spinee.2014.03.046 ◽

2014 ◽

Vol 14 (9) ◽

pp. 2224-2230 ◽

Cited By ~ 3

Author(s):

In-Hoo Ra ◽

Woo-Kie Min

Keyword(s):

Cervical Spine ◽

Clinical Assessment ◽

Screw Fixation ◽

Lateral Mass ◽

Lateral Mass Screw ◽

Fixation Technique ◽

Subaxial Cervical Spine

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Translaminar Screw Fixation in the Subaxial Cervical Spine

Spine ◽

10.1097/brs.0b013e31824c70ef ◽

2012 ◽

Vol 37 (12) ◽

pp. E745-E751 ◽

Cited By ~ 18

Author(s):

Matthew D. Alvin ◽

Kalil G. Abdullah ◽

Michael P. Steinmetz ◽

Daniel Lubelski ◽

Amy S. Nowacki ◽

...

Keyword(s):

Cervical Spine ◽

Screw Fixation ◽

Subaxial Cervical Spine ◽

Translaminar Screw Fixation ◽

Translaminar Screw

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LEVEL OF EVIDENCE IN THE PLACEMENT OF TRANSPEDICULAR SCREWS IN SUBAXIAL CERVICAL SPINE

Coluna/Columna ◽

10.1590/s1808-185120161502155441 ◽

2016 ◽

Vol 15 (2) ◽

pp. 145-150 ◽

Cited By ~ 2

Author(s):

Cristóbal Herrera Palacios ◽

Armando Fabio Ramos Guerrero ◽

Gustavo Casas Martínez ◽

Alfredo Javier Moheno Gallardo ◽

Silvestre Fuentes Figueroa

Keyword(s):

Cervical Spine ◽

Health Care Professionals ◽

Pedicle Screws ◽

High Energy ◽

Cervical Region ◽

Level Of Evidence ◽

Safety And Efficacy ◽

Subaxial Cervical Spine ◽

Freehand Technique ◽

Grade Of Recommendation

ABSTRACT The high-energy trauma mainly involves vertebral lesions and 6% occur in the cervical region. This poses a challenge to spine surgeons in surgical decision-making, both in terms of approach as the instrumentation. International recommendations establish that the procedures performed are reproducible, safe, and effective. The techniques for placement of pedicle screws are complicated and have been based on intraoperative navigation (limited by cost) and fluoroscopy (greater exposure of health care professionals and patients to radiation). Therefore, the freehand technique is an option. The goal was to identify the level of evidence and grade of recommendation in the medical literature regarding the safety and efficacy of pedicle screw instrumentation with freehand technique in subaxial cervical spine. To this end, we carried out a systematic review with the following MeSH terms: safety, efficacy, vertebral artery. Articles were evaluated twice in a standardized and blind way by two observers skilled in systematic analysis, after CLEIS 3401 authorization in November 2014. Due to the nature of the study and the variables, articles with a high level of evidence and grade of recommendation were not found. Level of Evidence obtained on safety and efficacy in the placement of pedicle screws in subaxial column with freehand technique: 2b. Degree of Recommendation obtained on safety and efficacy in the placement of pedicle screws in subaxial column with freehand technique: B, favorable recommendation.

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