Significance of laminar screw fixation in the subaxial cervical spine.
METHODS
We retrospectively reviewed 11 patients who underwent laminar screw fixation in the subaxial cervical spine. In 4 patients, laminar screws were inserted for posterior cervical arthrodesis, and in 7 patients it was used for fixation of the open laminae during laminoplasty.


OBJECTIVE
In this study, the author describes the technique and surgical results of translaminar screw placement in the subaxial cervical spine.


BACKGROUND
The use of laminar screws for fixation of the second cervical vertebra and upper thoracic vertebrae has been introduced as an important technique in spinal surgery because they can avoid injury to adjacent neurovascular structures. However, there have been no reports of translaminar screw use in the subaxial spine including C7. In this study, we describe the use of translaminar screws for fixation of the subaxial cervical spine in cases of degenerative or traumatic spine disease.


METHODS
Between June 2006 and March 2007, 34 translaminar screws were placed in 11 patients to treat trauma or degenerative disease: 6 at C7, 6 at C6, 7 at C5, 7 at C4, 7 at C3, and 1 at T1. There were 6 women and 5 men. The ages ranged from 23 to 87 years with a mean age of 61.3 years. All patients were evaluated at 6 weeks, as well as at 3 and 6 months using flexion and extension lateral radiographs. Patients requiring fusion were also evaluated with computed tomography at 3 and 6 months to verify arthrodesis.


RESULTS
The mean follow-up period was 5.7 months, at which time there was no significant complications from laminar screw placement, except for 2 asymptomatic breaches of the dorsal lamina cortex. Sound bone fusion was identified in cases where arthrodesis was the goal. No screw pullout or avulsion was identified in the laminoplasty cases.


CONCLUSIONS
The translaminar screw method avoided damaging vascular structures, especially when the vertebral artery courses in the C7 transverse foramen, and it maintains solid stabilization of the subaxial cervical spine. This technique has 2 important advantages to currently used techniques: it is simpler and is not limited by the position of vascular structures. Therefore, it may be applicable to a wider number of patients, especially as it may be used in the subaxial cervical spine.
Hong
Jae Taek
JT
Department of Neurosurgery, Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea. jatagi15@paran.com
Sung
Jae Hoon
JH
Son
Byung Chul
BC
Lee
Sang Won
SW
Park
Chun Kun
CK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000601:surgery*; D001863:Bone Screws / Q000592:standards*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D016268:Internal Fixators / Q000592:standards; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery