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Posterior Fusion in Patients with Trauma, Instability, and Tumor of the Cervical Spine

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Abstract

Trauma, instabilities and tumors of the cervical spine are treated with established methods of surgery. Therefore, anterior fusion is considered to be a standardized procedure for the lower cervical spine, while posterior and anterior instrumentation facilitates stabilization of the upper cervical spine. However, special situations that particularly require posterior instrumentation in traumatic lesions, tumor or other kinds of instabilities arise again and again. Neurological deficit symptoms, bone quality and related diseases fundamentally lead to a decision of posterior access and fusion. Different pathologies and corresponding reasons for posterior surgical interventions on the cervical spine are described in this paper and discussed using the current literature.

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References

  1. Grob D, Jeanneret B, Aebi M, Markwalder TM. Atlantoaxial fusion with transartikulär screw fixation. J Bone Joint Surg [Br] 1991;73:972–976.

    CAS  Google Scholar 

  2. Magerl F, Seemann PS. Stable posterior fusion of the atlas and axis by transarticular screw fixation. In: Kehr P, Weidner A, eds. Cervical spine I. Wien: Springer, 1986:322–327.

    Google Scholar 

  3. Blauth M, Tscherne H. Untere Halswirbelsäule. In: Tscherne H, Blauth M (eds) Tscherne Unfallchirurgie. Springer, Berlin 1998, pp 153–240.

    Google Scholar 

  4. Tscherne H, Illgner A. Ventrale spondylodese der Halswirbelsäule. Operat Orthopäd Traumatol 1991;3:147–157.

    Article  Google Scholar 

  5. Coe JD, Warden KE, Sutterlin CE, McAfee PC. Biomechanical evaluation of cervical spinal stabilization methods in a human cadaveric model. Spine 1989;14:1122–1131.

    Article  CAS  PubMed  Google Scholar 

  6. Capen DA, Garland DE, Waters RL. Surgical stabilization odf the cervical spine: a comparative analysis of anterior and posterior spine fusions. Clin Orthop 1985;196:229–237.

    PubMed  Google Scholar 

  7. Aebi M, Mohler J, Zäch G, Morscher E. Analysis of 75 operated thoracolumbar fractures and fracture dislocations with and without neurological deficit. Arch Orthop Trauma Surg 1986;105:100–112.

    Article  CAS  PubMed  Google Scholar 

  8. Detwiler KN, Loftus CM, Godersky JC, Menezes AH. Management of cervical spine injuries in patients with ankylosing spondylitis. J Neurosurg 1990;72:210–215.

    Article  CAS  PubMed  Google Scholar 

  9. Graham B, Van Peteghem PK. Fractures of the spine in ankylosing spondylitis: diagnosis, treatment and complications. Spine 1989;14:803–807.

    Article  CAS  PubMed  Google Scholar 

  10. Amamilo S. Fractures of the cervical spine in patients with ankylosing spondylitis. Orthop Rev 1989;18:339–344.

    CAS  PubMed  Google Scholar 

  11. Murray GC, Persellin RH. Cervical fracture complicating ankylosing spondylitis: a report of eight cases and review of the literature. Am J Med 1981;70:1033–1041.

    Article  CAS  PubMed  Google Scholar 

  12. Dreghorn CR, Newman RJ, Hardy GJ, Dickson RA. Primary tumors of the axial skeleton: experience of the Leeds regional bone tumor regestry. Spine 1990;15:137–140.

    Article  CAS  PubMed  Google Scholar 

  13. Wong DA, Fornasier VL, MacNab I. Spinal metastases: the obvious, the occult, and the impostors. Spine 1990;15:1–4.

    Article  CAS  PubMed  Google Scholar 

  14. Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S. Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine 1990;15:1110–1113.

    Article  CAS  PubMed  Google Scholar 

  15. Levine AM, Edwards CC. Fractures of the atlas. J Bone Joint Surg Am 1991;73:680–691.

    CAS  PubMed  Google Scholar 

  16. Flower JL, Sanhu A, Fraser RD. A reviews of fractures of the atlas vertebrae. J Spine Disord 1990;3:19–24.

    Google Scholar 

  17. McGiure RA Jr, Harkey HL. Primary treatment of instable Jefferson’s fractures. J Spine Disord 1995;8:233–236.

    Google Scholar 

  18. Kesterson L, Benzel E, Orrison W, Coleman J. Evaluation and treatment of atlas burst fractures (Jefferson fractures). J Neurosurg 1991;75:213–220.

    Article  CAS  PubMed  Google Scholar 

  19. Jeanneret B, Magerl F. Primary posterior fusion in odontoid fractures: indications, technique and results in transarticular screw fixation. J Spine Disord 1992;5:464–475.

    Article  CAS  Google Scholar 

  20. Coyne TJ, Fehlings MG, Wallace MC, Bernstein M, Tator CH. C1–C2 posterior cervical fusion: longterm evaluation of results and efficiency. Neurosurgery 1995;37:688–693.

    Article  CAS  PubMed  Google Scholar 

  21. Müller EJ, Muhr G. Wirbelsäulenverletzungen. Thieme 1997;54-57.

  22. Böhm H, Kayser R, El Saghir H, Heyde CE. Die direkte Osteosynthese instabiler Atlasfrakturen Gehweiler Typ III. Unfallchirurg 2006;9:754–760.

    Article  Google Scholar 

  23. Hadley MN, Dickman CA, Browner CM, Sonntag VKH. Acute traumatic atlas fractures: management and long term outcome. Neurosurgery 1988;23:31–35.

    Article  CAS  PubMed  Google Scholar 

  24. Song WS, Chiang CY, Chen CY, Lin SZ, Liu MY. A simple method for diagnosing traumatic occlusion of the vertebral artery and the craniovertebral junction. Spine 1994;19:837–839.

    Article  CAS  PubMed  Google Scholar 

  25. Hofmeister M, Bühren V. Therapeutic concept for injuries of the lower cervical spine. Orthopaede 1999;28:401–413.

    Article  CAS  Google Scholar 

  26. Grossmann MD, Reilly PM, Gillett T, Gillett D. National survey of the incidence of cervical spine injury and approachto cervical spine clearance in US trauma centers. J Trauma 1999;47:684–690.

    Article  Google Scholar 

  27. Blauth M. Verletzungen der Halswirbelsäule. In: Stürmer K, ed. Leitlinien Unfallchirurgie, Überarb. version. Thieme: Stuttgart 1998.

    Google Scholar 

  28. West OC, Anbari MM, Pilgram TK, Wilson AJ. Acute cervical spine trauma: diagnostic performance of single-view versus three-view-radiographic screening. Radiology 1997;204:819–823.

    CAS  PubMed  Google Scholar 

  29. Brunette DD, Rockswold GL. Neurologic recovery following rapid spinal realignment for complete cervical spinal cord injury. J Trauma 1987;27:445–447.

    Article  CAS  PubMed  Google Scholar 

  30. Lee AS, Mclean JCB, Newton DA. Rapid traction for reduction of cervical spine dislocations. J Bone Joint Surg Br 1994;76:352–356.

    CAS  PubMed  Google Scholar 

  31. Mirza SK, Krengel WF, Chapman JR, et al. Early versus delayed surgery for acute cervical spinal cord injury. Clin Orthop Relat Res 1999;359:104–114.

    Article  PubMed  Google Scholar 

  32. Grauer JN, Vaccaro AR, Beiner JM, et al. Similarities and differences in the treatment of spine trauma between surgical specialities and location of practice. Spine 2004;29:685–696.

    Article  PubMed  Google Scholar 

  33. Kossmann T, Trease L, Freedman I, Malham G. Damage control surgery for spine trauma. Injury 2004;35:661–670.

    Article  PubMed  Google Scholar 

  34. Katscher S, Verheyden AP. Standards bei der Behandlung von Frakturen und Instabilitäten der HWS zwischen C3 und C7. Trauma Berufskrankh 2003;5:225–230.

    Article  Google Scholar 

  35. Blauth M, Schmidt U, Dienst M, et al. Longterm outcome of 57 patients after ventral interbody spondylodesis of the lower cervical spine. Unfallchirurg 1996;99:925–939.

    Article  CAS  PubMed  Google Scholar 

  36. Caspar W, Barbier DD, Klara PM. Anterior cervical fusion and Caspar plate stabilization for cervical trauma. Neurosurgery 1989;25:491–502.

    Article  CAS  PubMed  Google Scholar 

  37. Aggarwall et al. Cervical spine involvement in rheumatoid arthritis: prevalence and relationship with overall disease severity. J Assoc Physicians India 1996;44:468–471.

    Google Scholar 

  38. Castro S, et al. Cervical spine involvement in rheumatoid arthritis: a clinical, neurological and radiological evaluation. Clin Exp Rheumatol 1994;12:369–374.

    CAS  PubMed  Google Scholar 

  39. Kandziora F, Mittlmeier T, Kerschbaumer F. Stage-related surgery for cervical spine instability in rheumatoid arthritis. Eur Spine J 1999;8:371–381.

    Article  CAS  PubMed  Google Scholar 

  40. Giner A, Keschbaumer F, Bauer R. Spondylarthritis rheumatica der HWS: Prävalenz und operative therapie. Z Rheuma 1983;43:4–17.

    Google Scholar 

  41. Kauooi M, Hakala M. Prevalence of cervical spine subluxations and dislocations in a community-based rheumatoid arthritis population. Scand J Rheumatol 1994;23:133–136.

    Article  Google Scholar 

  42. Boden SD. Rheumatoid arthritis of the cervical spine: surgical decision making based on predictiors of paralysis and recovery. Spine 1994;19:2275–2280.

    Article  CAS  PubMed  Google Scholar 

  43. Conlon PW, Isdale IC, Rose BS. Rheumatoid arthritis of the cervical spine: an analysis of 333 cases. Ann Rheum Dis 1966;25:120–126.

    CAS  PubMed  Google Scholar 

  44. Hugo H, Iwano K. Surgical treatment of subaxial cervical myelopathy in rheumatoid arthritis. J Bone Joint Surg Br 1991;73:474–480.

    Google Scholar 

  45. Brattström H, Granholm L. Chirurgie der Halswirbelsäule bei Patienten mit rheumatoider Arthritis. Orthopädie 1973;2:118–120.

    Google Scholar 

  46. Brattström H, Granholm L. Atlanto-axial fusion in rheumatoid arthritis: a new method of fixation with wire and bone cement. Acta Orthop Scand 1976;47:619–628.

    Article  PubMed  Google Scholar 

  47. Grob D, et al. Posterior occipito-cervical fusion in rheumatoid arthritis. Arch Orthop Trauma Surg 1990;110:38–44.

    Article  CAS  PubMed  Google Scholar 

  48. Gschwend N, Scheier M, Munzinger U. Entzündliche Veränderungen der Wirbelsäule bei chronischer Polyarthritis. Orthopädie 1981;10:155–168.

    CAS  Google Scholar 

  49. Ransford AO, et al. Craniocervical instability treated by contoured loop fixation. J Bone Joint Surg Br 1986;68:173–177.

    CAS  PubMed  Google Scholar 

  50. Grob D, Magerl F. Surgical stabilization of C1 and C2 fractures. Orthopäde 1987;16:46–54.

    CAS  PubMed  Google Scholar 

  51. Grob et al. Atlanto-axial fusion with transarticular screw fixation. J Bone Joint Surg Br 1991;73:972–976.

    CAS  PubMed  Google Scholar 

  52. Kerschbaumer F, Kerschbaumer GY, Kandziora F. Operative Therapie der rheumatischen Halswirbelsäule. Z Orthop Unfall 2007;145:655–673.

    Article  CAS  PubMed  Google Scholar 

  53. Kraus DR, et al. Incidence of subaxial subluxation in patients with generalized rheumatoid arthritis who have had previous occipital cervical fusions. Spine 1991;16:486–489.

    Article  Google Scholar 

  54. McMaster MJ. Osteotomy of the cervical spine in ankylosing spondylitis. J Bone Joint Surg Br 1997;79:197–203.

    Article  CAS  PubMed  Google Scholar 

  55. Miller FH, Rogers L. Fractures of the dens complicating ankylosing spondylitis with atlantooccipital fusion. J Rheumatol 1991;18:771–774.

    CAS  PubMed  Google Scholar 

  56. Ramos-Remus C, et al. Frequency of atlantoaxial subluxation and neurologic involvement in patients with ankylosing spondylitis. J Rheumatol 1995;22:2120–2125.

    CAS  PubMed  Google Scholar 

  57. Olerud C, Frost A, Bring J. Spinal fractures in patients with ankylosing spondylitis. Eur Spine J 1996;5:51–55.

    Article  CAS  PubMed  Google Scholar 

  58. Peh WC, Ho EK. Fracture of the odontoid peg in ankylosing spondylitis: case report. J Trauma 1995;38:361–363.

    Article  CAS  PubMed  Google Scholar 

  59. Rowed DW. Management of cervical spine cord injury in ankylosing spondylitis: the intervertebral disc as a cause of cord compression. J Neurosurg 1992;77:241–246.

    Article  CAS  PubMed  Google Scholar 

  60. Ho EK, Leong JC. Traumatic tetraparesis: a care neurologic complication in ankylosing spondylitis with ossification of posterior longitudinal ligament of the cervical spine: a case report. Spine 1987;12:403–405.

    Article  CAS  PubMed  Google Scholar 

  61. Koh WH, Garrett SL, Calin A. Cervical spine surgery in ankylosing spondylitis: is the outcome good?. Clin Rheumatol 1997;16:466–470.

    Article  CAS  PubMed  Google Scholar 

  62. Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain 1972;95:87–100.

    Article  CAS  PubMed  Google Scholar 

  63. Santavirta S, et al. Atlanto-axial subluxation in patients with seronegative spondylarthirits. Rheumatol Int 1987;7:43–46.

    Article  CAS  PubMed  Google Scholar 

  64. Shimizu K, et al. Correction of kyphotic deformity of the cervical spine in ankylosing spondylitis using general anesthesia and internal fixation. J Spinal Disord 1996;9:540–543.

    Article  CAS  PubMed  Google Scholar 

  65. Di Lorenzo N, Delfini R, Ciappetta P, Cantore G, et al. Primary tumors of the cervical spine: surgical experience with 38 case. Surg Neurol 1992;38:12–18.

    Article  Google Scholar 

  66. Schulte M, Kinzl L, Mutschler W. Chirurgische therapie von Wirbelmetastasen. Chirurg 1992;63:912–916.

    CAS  PubMed  Google Scholar 

  67. Phillips E, Levine AM. Metastatic lesions of the upper cervical spine. Spine 1989;14:1072–1077.

    Article  Google Scholar 

  68. Laus M, Pignatti G, Malaguti MC, Alfonso C, et al. Anterior extraoral surgery to the upper cervical spine. Spine 1996;15:1687–1693.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Trauma, Plastic and Reconstructive Surgery, University of Leipzig, Leipzig, Germany

    Dr. Hans-Joachim Riesner, Sebastian Katscher, Thomas Blattert & Christoph Josten

  2. Department of TraumaPlastic and Reconstructive Surgery, University of Leipzig, Liebigstr 20, 04103, Leipzig, Germany

    Dr. Hans-Joachim Riesner

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  1. Dr. Hans-Joachim Riesner
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  2. Sebastian Katscher
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Correspondence to Dr. Hans-Joachim Riesner.

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Hans-Joachim Riesner, D., Katscher, S., Blattert, T. et al. Posterior Fusion in Patients with Trauma, Instability, and Tumor of the Cervical Spine. Eur J Trauma 35, 562–579 (2009). https://doi.org/10.1007/s00068-009-8057-9

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