Lower cervical spine injury treated with lateral mass plates and pedicle screws through posterior approach.
OBJECTIVE
To treat injury of the lower cervical spine C6 to C7 with cervical lateral mass plates and T1 pedicle screws through posterior approach.


METHODS
The data of 8 patients with lower cervical spine C6 or C7 injury (6 patients with fracture and dislocation in C6 and C7 and 2 with fracture in C7) were analyzed retrospectively in this study. For the preoperative American Spinal Injury Association (ASIA) classification, Grade C was found in 3 cases and Grade D in 5 cases. Screws were placed on the lateral masses and the first thoracic pedicle with Margerl technique. Lamina or facet bone allografting was used to achieve a long-term stability.


RESULTS
All the 8 patients were followed up for 5-37 months (mean: 15 months). No operative death occurred. There were no examples of aggravation of spinal cord injury or vertebral artery injury, cerebrospinal fluid leak, nerve roots injury, screw malposition or back-out, loose of alignment or implant failure. Clinical symptoms and ASIA classification were improved in all the patients. Postoperative MRI scanning confirmed the satisfactory screw placement in all the cases.


CONCLUSIONS
Lateral mass plates and pedicle screws through posterior approach are safe and beneficial for patients with lower cervical spine C6 or C7 injury.
Zhao
Xue-ling
XL
Department of Orthopaedics, First Affiliated Hospital, Kunming Medical College, Kunming 650032, China. zhaoxuelin@vip.km169.net
Zhao
Hong-bin
HB
Wang
Bin
B
Zhu
Xiao-song
XS
Li
Lin-zhi
LZ
Zhang
Chun-qiang
CQ
D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016103:Spinal Fractures / Q000175:diagnosis* / Q000601:surgery*; D013124:Spinal Injuries / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome