title: Posterior plating of the cervical spine.
abstract: A retrospective review of 36 patients treated with posterior cervical plating and autogenous iliac crest bone graft was performed to evaluate the results of posterior cervical plating in terms of fusion, outcome, technique, and complications. Numerous methods of cervical stabilization have been described with varying fusion rates and complications. Compared to wiring techniques, there is little information concerning the results of posterior cervical plating. Thirty-six patients with cervical instability underwent posterior plating with lateral mass screw fixation. Twenty-two had acute traumatic instability, four had late traumatic instability, six had metastatic disease, and four had postlaminectomy spondylotic instability. A Minerva brace was worn postoperatively for 3 months and fusion was assessed by bone incorporation on plain films, stable dynamic flexion-extension views, and absence of neck pain. Postoperative MRI and CT imaging was assessed in those patients who underwent these modalities. Fusion occurred at an average of 3 months in all patients. One patient demonstrated postoperative neurologic deterioration, but this resolved with subsequent decompression. Six patients had loosening of short, unicortical screws, but this did not affect the fusion result in five of these patients. The use of titanium implants allowed operative CT and MR imaging without the excessive artifact associated with stainless steel implants. Posterior cervical plating with lateral mass fixation and bone grafting offers a reliable method of achieving fusion. Bicortical lateral mass screws are less likely to loosen than unicortical screws, and no major complications occurred.
authors.affiliation: Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43699-0008, USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Ebraheim
authors.forename: R E
authors.initials: RE
authors.lastname: Rupp
authors.forename: E R
authors.initials: ER
authors.lastname: Savolaine
authors.forename: J A
authors.initials: JA
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D007085:Ilium; D007593:Joint Instability / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013125:Spinal Neoplasms / Q000150:complications / Q000601:surgery; D013193:Stainless Steel; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D013193:Stainless Steel; D014025:Titanium