Occipital-cervical fusion using the Locksley intersegmental tie bar technique: long-term experience with 19 patients.
BACKGROUND
The management of lesions at the craniocervical junction presents unique difficulties for the spine surgeon. The complexity of this region creates a variety of mechanical forces that challenge any fusion construct. An understanding of the ligamentous, bone and vascular structures in this region is critical.


OBJECTIVE
To describe a method of occipital-cervical fusion with long-term follow-up.


METHODS
Retrospective case series.


METHODS
Twenty-one consecutive patients with craniocervical compression and/or instability who were treated using the Locksley intersegmental tie bar technique.


METHODS
Neurologic function, fusion, postoperative complications.


METHODS
Patients with craniocervical instability underwent occipital-cervical fusion using the Locksley intersegmental tie bar technique. The pathologic processes causing compression and/or instability at the craniocervical junction, as well as the patients' pre- and postoperative neurologic status, are reported.


RESULTS
Solid fusion was attained in all 19 patients surviving at 2 years. Two patient deaths were reported in this series in the early postoperative period because of systemic disease.


CONCLUSIONS
This approach allows for rigid, immediate stabilization of this region. An external orthosis is most often not required. This technique has unique applicability to patients where the normal ligamentous and bone structures are weakened because of underlying disease or injury.
Section of Neurosurgery, Medical College of Georgia, 1120 15th Street, Room BI-W3088, Augusta, GA 30912, USA. jvender@mail.mcg.edu
John R
JR
Vender
Paul J
PJ
Houle
Steven
S
Harrison
Dennis E
DE
McDonnell
D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*