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Alternative Means of Posterior Cervical Stabilization

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Degenerative Cervical Myelopathy and Radiculopathy

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Abstract

The posterior approach is commonly performed in the treatment of multilevel degenerative cervical myelopathy (DCM) with spinal cord compression. Both posterior laminoplasty and laminectomy with fusion can achieve adequate decompression of the spinal cord and obtain satisfactory neurologic outcomes. Lateral mass screw (LMS) fixation is the prevalent fixation technique for the posterior cervical approach. LMS fixation achieves a high fusion rate and is associated with a low complication profile. Neurologic injury, vascular injury, and hardware failure rarely occur in LMS cases. LMS has become the standard technique for posterior fixation in the subaxial cervical spine for various pathologies. Nevertheless, LMS fixation has its own limitations and isn’t indicated under certain circumstances. In such circumstances, alternative techniques including cervical pedicle screw, translaminar screw, and transfacet screw can be very useful for posterior cervical fixation instead of LMS. In this chapter, we will give a comprehensive explanation of these common alternatives for posterior cervical fixation.

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References

  1. Coe JD, Vaccaro AR, Dailey AT, et al. Lateral mass screw fixation in the cervical spine: a systematic literature review. J Bone Joint Surg Am. 2013;95(23):2136–43.

    Article  Google Scholar 

  2. Theologis AA, Burch S. Safety and efficacy of reconstruction of complex cervical spine pathology using pedicle screws inserted with stealth navigation and 3D image-guided (O-arm) technology. Spine (Phila Pa 1976). 2015;40(18):1397–406.

    Article  Google Scholar 

  3. Abumi K, Ito M, Sudo H. Reconstruction of the subaxial cervical spine using pedicle screw instrumentation. Spine (Phila Pa 1976). 2012;37(5):E349–56.

    Article  Google Scholar 

  4. Mahesh B, Upendra B, Vijay S, Arun K, Srinivasa R. Perforations and angulations of 324 cervical medial cortical pedicle screws: a possible guide to avoid lateral perforations with use of pedicle screws in lower cervical spine. Spine J. 2016;17(3):457–65.

    Article  Google Scholar 

  5. Ishikawa Y, Kanemura T, Yoshida G, et al. Intraoperative, full-rotation, three-dimensional image (O-arm)-based navigation system for cervical pedicle screw insertion. J Neurosurg Spine. 2011;15(5):472–8.

    Article  Google Scholar 

  6. Luther N, Iorgulescu JB, Geannette C, et al. Comparison of navigated versus non-navigated pedicle screw placement in 260 patients and 1434 screws: screw accuracy, screw size, and the complexity of surgery. J Spinal Disord Tech. 2015;28(5):E298–303.

    Article  Google Scholar 

  7. Heller JG, Silcox DH 3rd, Sutterlin CE 3rd. Complications of posterior cervical plating. Spine (Phila Pa 1976). 1995;20(22):2442–8.

    Article  CAS  Google Scholar 

  8. Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K. Complications of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine (Phila Pa 1976). 2000;25(8):962–9.

    Article  CAS  Google Scholar 

  9. Wright NM. Posterior C2 fixation using bilateral, crossing C2 laminar screws: case series and technical note. J Spinal Disord Tech. 2004;17(2):158–62.

    Article  Google Scholar 

  10. Ma W, Feng L, Xu R, et al. Clinical application of C2 laminar screw technique. Eur Spine J. 2010;19(8):1312–7.

    Article  Google Scholar 

  11. Hong JT, Sung JH, Son BC, Lee SW, Park CK. Significance of laminar screw fixation in the subaxial cervical spine. Spine (Phila Pa 1976). 2008;33(16):1739–43.

    Article  Google Scholar 

  12. Dorward IG, Wright NM. Seven years of experience with C2 translaminar screw fixation: clinical series and review of the literature. Neurosurgery. 2011;68(6):1491–9; discussion 1499.

    Article  Google Scholar 

  13. Reddy C, Ingalhalikar AV, Channon S, Lim TH, Torner J, Hitchon PW. In vitro biomechanical comparison of transpedicular versus translaminar C-2 screw fixation in C2-3 instrumentation. J Neurosurg Spine. 2007;7(4):414–8.

    Article  Google Scholar 

  14. Shin SI, Yeom JS, Kim HJ, Chang BS, Lee CK, Riew KD. The feasibility of laminar screw placement in the subaxial spine: analysis using 215 three-dimensional computed tomography scans and simulation software. Spine J. 2012;12(7):577–84.

    Article  Google Scholar 

  15. Cardoso MJ, Dmitriev AE, Helgeson MD, et al. Using lamina screws as a salvage technique at C-7: computed tomography and biomechanical analysis using cadaveric vertebrae. Laboratory investigation. J Neurosurg Spine. 2009;11(1):28–33.

    Article  Google Scholar 

  16. Cho W, Le JT, Shimer AL, Werner BC, Glaser JA, Shen FH. Anatomy of lamina in the subaxial cervical spine with the special reference to translaminar screws: CT and cadaveric analysis with screw trajectory simulation. Clin Spine Surg. 2017;30(5):E535–9.

    Article  Google Scholar 

  17. Alvin MD, Abdullah KG, Steinmetz MP, et al. Translaminar screw fixation in the subaxial cervical spine: quantitative laminar analysis and feasibility of unilateral and bilateral translaminar virtual screw placement. Spine (Phila Pa 1976). 2012;37(12):E745–51.

    Article  Google Scholar 

  18. Takayasu M, Hara M, Yamauchi K, Yoshida M, Yoshida J. Transarticular screw fixation in the middle and lower cervical spine. Technical note. J Neurosurg. 2003;99(1 Suppl):132–6.

    PubMed  Google Scholar 

  19. Miyanji F, Mahar A, Oka R, Newton P. Biomechanical differences between transfacet and lateral mass screw-rod constructs for multilevel posterior cervical spine stabilization. Spine (Phila Pa 1976). 2008;33(23):E865–9.

    Article  Google Scholar 

  20. Aydogan M, Enercan M, Hamzaoglu A, Alanay A. Reconstruction of the subaxial cervical spine using lateral mass and facet screw instrumentation. Spine (Phila Pa 1976). 2012;37(5):E335–41.

    Article  Google Scholar 

  21. Liu G, Xu R, Ma W, Sun S, Feng J. Anatomical considerations for the placement of cervical transarticular screws. J Neurosurg Spine. 2011;14(1):114–21.

    Article  Google Scholar 

  22. Milchteim C, Yu WD, Ho A, O’Brien JR. Anatomical parameters of subaxial percutaneous transfacet screw fixation based on the analysis of 50 computed tomography scans: clinical article. J Neurosurg Spine. 2012;16(6):573–8.

    Article  Google Scholar 

  23. Abumi K. Cervical spondylotic myelopathy: posterior decompression and pedicle screw fixation. Eur Spine J. 2015;24(Suppl 2):186–96.

    Article  Google Scholar 

  24. Ahmad F, Sherman JD, Wang MY. Percutaneous trans-facet screws for supplemental posterior cervical fixation. World Neurosurg. 2012;78(6):716. e711–714.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurological Surgery and Rehabilitation Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Hsuan-Kan Chang, David McCarthy & Michael Y. Wang

Authors
  1. Hsuan-Kan Chang
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  2. David McCarthy
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  3. Michael Y. Wang
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Corresponding author

Correspondence to Michael Y. Wang .

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Editors and Affiliations

  1. Columbia University Medical Center, New York, NY, USA

    Michael G. Kaiser

  2. Atlanta Brain and Spine Care, Atlanta, GA, USA

    Regis W. Haid

  3. Duke University Health System, Durham, NC, USA

    Christopher I. Shaffrey

  4. Toronto Western Hospital, University of Toronto, Toronto, ON, Canada

    Michael G. Fehlings

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Chang, HK., McCarthy, D., Wang, M.Y. (2019). Alternative Means of Posterior Cervical Stabilization. In: Kaiser, M., Haid, R., Shaffrey, C., Fehlings, M. (eds) Degenerative Cervical Myelopathy and Radiculopathy . Springer, Cham. https://doi.org/10.1007/978-3-319-97952-6_30

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  • DOI: https://doi.org/10.1007/978-3-319-97952-6_30

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97951-9

  • Online ISBN: 978-3-319-97952-6

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