Paravertebral foramen screw fixation for posterior cervical spine surgery: clinical case series

2021 ◽  
pp. 1-8
Author(s):  
Tomoaki Shimizu ◽  
Masao Koda ◽  
Tetsuya Abe ◽  
Tomoyuki Asada ◽  
Kosuke Sato ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Revision Surgery ◽  
Posterior Wall ◽  
Cervical Fusion ◽  
Screw Loosening ◽  
Transverse Foramen ◽  
Fusion Surgery ◽  
Cervical Spine Surgery ◽  
Intermediate Group ◽  
Posterior Cervical Fusion

OBJECTIVE The goal of this study was to clarify the clinical utility of paravertebral foramen screws (PVFSs) and to determine intraoperative indicators for appropriate screw placement during posterior cervical fusion surgery to improve its safety. METHODS The authors included data from 46 patients (29 men and 17 women, mean age 61.7 years) who underwent posterior cervical spine surgery with 94 PVFSs. Of the 94 PVFSs, 77 were used in C6, 9 in C3, 5 in C4, and 3 in C5. According to the cervical lateral radiographic view, the authors divided the 94 PVFSs into 3 groups as follows: a longer group, in which the tip of PVFS was located anteriorly from the line of the posterior wall of the vertebral body (> +0 mm); an intermediate group, in which the screw tip was located up to 2 mm posteriorly to the posterior wall of the vertebral body (–2 to 0 mm); and a shorter group, in which the screw tip was located more than 2 mm posteriorly (< –2 mm). The accuracy of screw placement was assessed using CT imaging in the axial plane, and the proportion of screws penetrating a vertebral foramen or a transverse foramen was compared between the 3 groups. Screw loosening was defined as a lucent zone around the screw evaluated on cervical radiography at 1 year after surgery. Complications related to PVFS insertion and revision surgery related to PVFS were evaluated. RESULTS The authors classified 25 PVFSs into the longer group, 43 into the intermediate group, and 26 into the shorter group. The proportion of screws penetrating a vertebral foramen was largest in the shorter group, and the proportion penetrating a transverse foramen was largest in the longer group. Screw loosening was confirmed for 3 of 94 PVFSs. One PVFS inserted in C6 unilaterally within a long construct from C2 to C7 showed loosening, but it did not cause clinical symptoms. Revision surgery was required for 2 PVFSs inserted in C3 bilaterally as the lower instrumented vertebra in occiput–cervical fusion because they pulled out. There was no neurovascular complication related to PVFS insertion. CONCLUSIONS PVFSs are useful for posterior cervical fusion surgery as alternative anchor screws, and the line of the posterior wall of the cervical body on lateral fluoroscopic images is a potential intraoperative reference to indicate an appropriate trajectory for PVFSs.

Evaluation of Cervical Spine Surgery by Postoperative Myelography

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 416-421 ◽  
Author(s):  
Charles A. Fager
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Nerve Root ◽  
Spontaneous Remission ◽  
Cord Compression ◽  
Cervical Disc ◽  
Nerve Root Compression ◽  
Cervical Fusion ◽  
Cervical Spine Surgery ◽  
Cervical Spine Fusion

Abstract After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion.

86. Rate of revision surgery following multilevel posterior cervical fusion at the cervicothoracic junction

2019 ◽  
Vol 19 (9) ◽  
pp. S42
Author(s):  
Bryan T. Head ◽  
Christopher D. Chaput ◽  
Mark D. Rahm ◽  
Robert S. Russell
Keyword(s):  
Revision Surgery ◽  
Cervical Fusion ◽  
Cervicothoracic Junction ◽  
Posterior Cervical Fusion

Cervical Alignment Following Posterior Cervical Fusion Surgery

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Subum Lee ◽  
Dae Chul Cho ◽  
Sung Woo Roh ◽  
Sang Ryong Jeon ◽  
Eun Ji Moon ◽  
...  
Keyword(s):  
Cervical Fusion ◽  
Fusion Surgery ◽  
Cervical Alignment ◽  
Posterior Cervical Fusion

scholarly journals Posterior cervical fusion with a luque suquare rod for fracture-dislocation of the cervical spine.

1988 ◽  
Vol 36 (3) ◽  
pp. 837-840
Author(s):  
Hiroto Oohira ◽  
Takashi Sakou ◽  
Norio Morimoto ◽  
Yoshiyuki Morizono ◽  
Kazunori Yone ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Fracture Dislocation ◽  
Cervical Fusion ◽  
Posterior Cervical Fusion

CERVICAL SPINE REOPERATION RATES AND HOSPITAL RESOURCE UTILIZATION AFTER INITIAL SURGERY FOR DEGENERATIVE CERVICAL SPINE DISEASE IN 12 338 PATIENTS IN WASHINGTON STATE

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. 1011-1023 ◽  
Author(s):  
Joseph T. King ◽  
Khalid M. Abbed ◽  
Grahame C. Gould ◽  
Edward C. Benzel ◽  
Zoher Ghogawala
Keyword(s):  
Cervical Spine ◽  
Length Of Stay ◽  
Primary Diagnosis ◽  
Hospital Charges ◽  
Fusion Surgery ◽  
Cervical Spine Surgery ◽  
Degenerative Cervical Spine ◽  
Reoperation Rates ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

Abstract OBJECTIVE Patients undergoing surgery for degenerative cervical spine disease may require future surgery for disease progression. We investigated factors related to the rate of additional cervical spine surgery, the associated length of stay, and hospital charges. METHODS The was a longitudinal retrospective cohort study using Washington state's 1998 to 2002 state inpatient databases and International Classification of Diseases–Ninth Revision–Clinical Modification (ICD-9) codes to analyze patients undergoing degenerative cervical spine surgery. Multivariate Poisson regression to identify patient and surgical factors associated with reoperation for degenerative cervical spine disease was used. Multivariate linear regressions to identify factors associated with length of stay and hospital charges adjusted for age, sex, year of surgery, primary diagnosis, payment type, discharge status, and comorbidities were also used. RESULTS A total of 12 338 patients underwent initial cervical spine surgeries from 1998 to 2002; the mean follow-up duration was 2.3 years, and 688 patients (5.6%) underwent a reoperation (2.5% per year). Higher reoperation rates were independently associated with younger patients (P &lt; 0.001) and a primary diagnosis of disc herniation with myelopathy (P = 0.011). Ventral surgery (P &lt; 0.001) and fusion (P &lt; 0.001) were both associated with lower rates of reoperation; however, a high correlation (Spearman's rho = 0.82; P &lt; 0.001) made it impossible to determine which factor was dominant. Longer length of stay was independently associated with nonventral approaches (+1.0 day; P &lt; 0.001) and fusion surgery (+0.8 day; P &lt; 0.001). Greater hospital charges were independently associated with nonventral approaches (+$2900; P &lt; 0.001) and fusion surgery (+$9600; P &lt; 0.001). CONCLUSION Patients undergoing surgery for degenerative cervical spine disease undergo reoperations at the rate of 2.5% per year. An initial ventral approach and/or fusion seem to be associated with lower reoperation rates. An initial nonventral approach and fusion were more expensive.

scholarly journals Tissue-Sparing Posterior Cervical Fusion With Interfacet Cages: A Systematic Review of the Literature

2019 ◽  
Vol 10 (2) ◽  
pp. 230-236
Author(s):  
Joseph L. Laratta ◽  
Karishma Gupta ◽  
William D. Smith
Keyword(s):  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Extensive Literature ◽  
Cervical Fusion ◽  
Cervical Spine Surgery ◽  
Radiographic Outcomes ◽  
Patient Reported ◽  
Posterior Cervical Fusion ◽  
Extensive Literature Search ◽  
Tissue Sparing

Study Design: Literature review. Objectives: Posterior cervical interfacet cages are an alternative to lateral mass fixation in patients undergoing cervical spine surgery. Recently, a percutaneous, tissue-sparing system for interfacet cage placement has been developed, however, there is limited clinical evidence supporting its widespread use. The aim was to review studies published on this system for patient reported outcomes, radiographic outcomes, intraoperative outcomes, and complications. Methods: Four electronic databases (PubMed, EMBASE, Scopus, and MEDLINE) were queried for original published studies that evaluated the percutaneous, tissue-sparing technique for posterior cervical fusion with interfacet cage placement. All studies reporting on open techniques and purely biomechanical studies were excluded. Results: The extensive literature search returned 7852 studies. After systematic review, a total of 7 studies met inclusion criteria. Studies were independently classified as retrospective or prospective cohort studies and each assessed by the GRADE criteria. Patient reported outcomes, radiographic outcomes, intraoperative outcomes, and complications were extracted from each study and presented. Conclusions: Tissue-sparing, posterior cervical fusion with interfacet cages may be considered a safe and effective surgical intervention in patients failing conservative management for cervical spondylotic disease. However, the quality of evidence in the literature is lacking, and controlled, comparative studies are needed for definitive assessment.

Relationship Between T1 Slope and Cervical Alignment Following Multilevel Posterior Cervical Fusion Surgery

Spine ◽  
2016 ◽  
Vol 41 (7) ◽  
pp. E396-E402 ◽  
Author(s):  
Seung-Jae Hyun ◽  
Ki-Jeong Kim ◽  
Tae-Ahn Jahng ◽  
Hyun-Jib Kim
Keyword(s):  
Cervical Fusion ◽  
Fusion Surgery ◽  
Cervical Alignment ◽  
T1 Slope ◽  
Posterior Cervical Fusion

scholarly journals Morphologic variations of the second cervical vertebra in Down syndrome compared with age-matched peers

2019 ◽  
Vol 30 (2) ◽  
pp. 175-181
Author(s):  
Ryan C. Hofler ◽  
Daniel M. Heiferman ◽  
Ayrin Molefe ◽  
Ryan LeDuc ◽  
Stephen J. Johans ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Cervical Spine ◽  
Vertebral Body ◽  
Posterior Wall ◽  
Coronal Plane ◽  
Atlantoaxial Instability ◽  
Transverse Foramen ◽  
The Mean ◽  
Axis Length ◽  
Age And Sex

OBJECTIVEAtlantoaxial instability is an important cause of pain and neurological dysfunction in patients with Down syndrome (DS), frequently requiring instrumented fusion of the upper cervical spine. This study provides a quantitative analysis of C2 morphology in DS patients compared with their peers without DS to identify differences that must be considered for the safe placement of instrumentation.METHODSA retrospective chart review identified age-matched patients with and without DS with a CT scan of the cervical spine. Three-dimensional reconstructions of these scans were made with images along the axis of, and perpendicular to, the pars, lamina, facet, and transverse foramen of C2 bilaterally. Two of the authors performed independent measurements of anatomical structures using these images, and the average of the 2 raters’ measurements was recorded. Pedicle height and width; pars axis length (the distance from the facet to the anterior vertebral body through the pars); pars rostrocaudal angle (angle of the pars axis length to the endplate of C2); pars axial angle (angle of the pars axis length to the median coronal plane); lamina height, length, and width; lamina angle (angle of the lamina length to the median coronal plane); and transverse foramen posterior distance (the distance from the posterior wall of the transverse foramen to the tangent of the posterior vertebral body) were measured bilaterally. Patients with and without DS were compared using a mixed-effects model accounting for patient height.RESULTSA total of 18 patients with and 20 patients without DS were included in the analysis. The groups were matched based on age and sex. The median height was 147 cm (IQR 142–160 cm) in the DS group and 165 cm (IQR 161–172 cm) in the non-DS group (p < 0.001). After accounting for variations in height, the mean pars rostrocaudal angle was greater (50.86° vs 45.54°, p = 0.004), the mean transverse foramen posterior distance was less (−1.5 mm vs +1.3 mm, p = 0.001), and the mean lamina width was less (6.2 mm vs 7.7 mm, p = 0.038) in patients with DS.CONCLUSIONSPatients with DS had a steeper rostrocaudal trajectory of the pars, a more posteriorly positioned transverse foramen posterior wall, and a narrower lamina compared with age- and sex-matched peers. These variations should be considered during surgical planning, as they may have implications to safe placement of instrumentation.

Posterior cervical fusion in children

1976 ◽  
Vol 45 (2) ◽  
pp. 211-215 ◽  
Author(s):  
Joe M. McWhorter ◽  
Eben Alexander ◽  
Courtland H. Davis ◽  
David L. Kelly
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
The Other ◽  
Congenital Absence ◽  
Cervical Fusion ◽  
Content Type ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Posterior Cervical Fusion ◽  
Fine Print

✓ Six cases of posterior cervical fusion with rib grafts in children are reported. Four of the children had sustained cervical spine injuries in accidents, and two had congenital absence of the odontoid. Three-level fusions (C1–3) were done in four children, and four-level fusions (C1–4) in two. One child died of unrelated causes 3 months after the operation. The other five children have been followed for 5 to 13 years. All are doing well and each has a remarkably supple, stable neck and no neurological deficit.

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