Fixation of fractures of the lower cervical spine using methylmethacrylate and wire: technique and results in 99 patients.
Surgical stabilization of traumatic fracture-dislocations of the lower cervical spine with wire and methylmethacrylate remains a controversial procedure. Yet, the resultant immediate fixation with minimal patient morbidity seems to indicate that this method provides an ideal stabilization construct. We describe and report the outcome of a technique of posterior cervical fixation with methylmethacrylate and wire for stabilization of traumatic fractures of the lower cervical spine. Over a 12-year period, 124 fracture-dislocations of the lower cervical spine in 99 patients (mean age, 32 years; range, 15-76 years) were treated at this institution using a posterior methylmethacrylate and wire technique. Eighty-two patients had a posterior element fracture; 28 had a vertebral compression with posterior ligamentous injury; and 14 had a ligamentous injury alone. Thirty-six patients were neurologically intact upon admission, while the rest had radiculopathy or partial or complete myelopathy. Ninety-one patients were available for follow-up [mean, 18.6 months; range, 1-100 months (8.33 years)]. Eighty-eight patients (97%) had a stable fixation and 77 (85%) had resumed preoperative activity or were working but with a residual deficit. Complications included fixation failure requiring a second operation in 3 patients, nonlethal pulmonary embolism in 2 patients, lethal pulmonary embolism in 1 patient, and a superficial wound infection in 3 patients (none affected the underlying fixation construct). These results indicate that this technique is a safe, simple, and effective method for stabilizing the lower cervical spine that allows rapid patient mobility with minimal morbidity.
Branch
C L
CL
Department of Neurosurgery, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, North Carolina.
Kelly
D L
DL
Davis
C H
CH
McWhorter
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D001864:Bone Wires; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D020366:Methylmethacrylate; D008768:Methylmethacrylates; D008875:Middle Aged; D009984:Orthopedic Fixation Devices
D001672:Biocompatible Materials; D008768:Methylmethacrylates; D020366:Methylmethacrylate