title: Fusion following lateral mass reconstruction in the cervical spine.
abstract: OBJECTIVE
  Recently, aggressive surgical techniques and a push toward en bloc resections of certain tumors have resulted in a need for creative spinal column reconstruction. Iatrogenic instability following these resections requires a thoughtful approach to adequately transfer load-bearing forces from the skull and upper cervical spine to the subaxial spine.
  
  
  METHODS
  The authors present a series of 7 cases in which lateral mass reconstruction with a cage or fibular strut graft was used to provide load-bearing support, including 1 case of bilateral cage placement.
  
  
  RESULTS
  The authors discuss the surgical nuances of en bloc resection of high cervical tumors and explain their technique for lateral mass cage placement. Additionally, they provide their rationale for the use of these constructs throughout the craniocervical junction and subaxial spine.
  
  
  CONCLUSIONS
  Lateral mass reconstruction provides a potential alternative or adjuvant method of restoring the load-bearing capabilities of the cervical spine.
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota; and.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Clarke
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Zadnik
authors.forename: Mari L
authors.initials: ML
authors.lastname: Groves
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sciubba
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Witham
authors.forename: Ali
authors.initials: A
authors.lastname: Bydon
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Wolinsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D013123:Spinal Fusion / Q000379:methods; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: IMRT = intensity modulated radiation therapy; cervical; en bloc resection; lateral mass cage; spinal reconstruction