Skip to main content
SpringerLink
Log in

Overview of Surgical Techniques and Implants

  • Chapter
  • First Online:
Manual of Spine Surgery

  • 3867 Accesses

Abstract

A posterior approach to the cervical spine is indicated in posteriorly situated lesions or as a supplement to anterior surgery. Great advancements in posterior instrumentation have been made over the last decades. Today, modern versatile rod-screw systems allow easy and stable fixation from the occiput to the upper thoracic spine. If surgery is indicated, the choice of the approach depends on etiology and location of the pathology and the functional spinal stability considering the options for appropriate decompression and stabilization. Posterior decompressive approaches are suited for cases of posteriorly situated lesions compressing the spinal cord and/or the exiting nerve roots. As an advantage, the posterior approach is relatively simple not being compromised by neural or vascular structures and can easily be extended if necessary. Also, the posterior bony elements are usually very strong, providing excellent purchase for implants even in the osteoporotic spine.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Abumi K, Takada T, Shono Y et al (1999) Posterior occipitocervical reconstruction using cervical pedicle screws and plate-rod systems. Spine 24:1425–1434

    Article  PubMed  CAS  Google Scholar 

  2. An HS, Gordin R, Renner K (1991) Anatomic considerations for plate-screw fixation of the cervical spine. Spine 16:S548–S551

    Article  PubMed  CAS  Google Scholar 

  3. Anderson RC, Ragel BT, Mocco J et al (2007) Selection of a rigid internal fixation construct for stabilization at the craniovertebral junction in pediatric patients. J Neurosurg 107(1 Suppl):36–42

    PubMed  Google Scholar 

  4. Brooks AL, Jenkins EB (1978) Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am 60:279–284

    PubMed  CAS  Google Scholar 

  5. Ebraheim NA, Lu J, Biyani A et al (1996) An anatomic study of the thickness of the occipital bone. Implications for occipitocervical instrumentation. Spine 21:1725–1730

    Article  PubMed  CAS  Google Scholar 

  6. Finn MA, Fassett DR, Mccall TD, Clark R et al (2008) The cervical end of an occipitocervical fusion: a biomechanical evaluation of 3 constructs. Laboratory investigation. J Neurosurg Spine 9:296–300

    Article  PubMed  Google Scholar 

  7. Foerster O (1927) Die Leitungsbahnen des Schmerzgefühls und die chirurgische Behandlung der Schmerzzustände. Urban & Schwar­zenburg, Berlin

    Google Scholar 

  8. Gallie WE (1939) Fractures and dislocations of the cervical spine. Am J Surg 46:495–499

    Article  Google Scholar 

  9. Gebhard JS, Schimmer RC, Jeanneret B (1998) Safety and accuracy of transarticular screw fixation C1-C2 using an aiming device. An anatomic study. Spine 23:2185–2189

    Article  PubMed  CAS  Google Scholar 

  10. Grob D, Bremerich FH, Dvorak J et al (2006) Transarticular screw fixation for osteoarthritis of the atlanto axial segment. Eur Spine J 15:283–291

    Article  PubMed  Google Scholar 

  11. Harms J, Melcher RP (2001) Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine 26:2467–2471

    Article  PubMed  CAS  Google Scholar 

  12. Jeanneret B (1996) Posterior rod system of the cervical spine: a new implant allowing optimal screw insertion. Eur Spine J 5:350–356

    Article  PubMed  CAS  Google Scholar 

  13. Jeanneret B, Schaeren S (2004) Posterior stabilization of the cervical and upper thoracic spine with the CerviFix®. Oper Orthop Traumatol 16:89–116

    Article  Google Scholar 

  14. Magerl F, Seemann PS (1987) Stable posterior fusion of the atlas and axis by transarticular screw fixation. In: Kehr P, Weidner A (eds) Cervical spine, vol 1. Springer, Vienna

    Google Scholar 

  15. Oda I, Abumi K, Sell LC et al (1999) Biomechanical evaluation of five different occipito-atlanto-axial fixation techniques. Spine 24:2377–2382

    Article  PubMed  CAS  Google Scholar 

  16. Olerud S, Olerud C (2001) The C1 claw device: a new instrument for C1-C2 fusion. Eur Spine J 10:345–347

    Article  PubMed  CAS  Google Scholar 

  17. Richter M, Wilke HJ, Kluger P et al (2000) Biomechanical evaluation of a new modular rod-screw implant system for posterior instrumentation of the occipito-cervical spine: in-vitro comparison with two established implant systems. Eur Spine J 9:417–425

    Article  PubMed  CAS  Google Scholar 

  18. Richter M, Mattes T, Cakir B (2004) Computer-assisted posterior instrumentation of the cervical and cervico-thoracic spine. Eur Spine J 13:50–59

    Article  PubMed  Google Scholar 

  19. Richter M (2005) Posterior instrumentation of the cervical spine using the neon occipito-cervical system part 2: cervical and cervicothoracic instrumentation. Oper Orthop Traumatol 17:579–600

    Article  PubMed  Google Scholar 

  20. Richter M, Schmidt R, Claes L et al (2002) Posterior atlantoaxial fixation: biomechanical in vitro comparison of six different techniques. Spine 27:1724–1732

    Article  PubMed  Google Scholar 

  21. Roy-Camille R, Saillant G, Judet T et al (1983) Traumatismes Recents Des Cinq Dernieres Vertebres Cervicales Chez L’Adulte (Avec et sans complication neurologique). Sem Hop 59:1479–1488

    PubMed  CAS  Google Scholar 

  22. Schaeren S, Jeanneret B (2002) Occipitocervical instrumentation. Tech Orthop 18:87–95

    Google Scholar 

  23. Sonntag VKH, Dickman CA (1993) Craniocervical stabilization. Clin Neurosurg 40:243–272

    PubMed  CAS  Google Scholar 

  24. Yoshida M, Neo M, Fujibayashi S, Nakamura T (2006) Comparison of the anatomical risk for vertebral artery injury associated with the C2-pedicle screw and atlantoaxial transarticular screw. Spine 31:E513–E517

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery/Spine, University Hospital, Spitalstrasse 21, 4031, Basel, Switzerland

    Stefan Schären M.D.

Authors
  1. Stefan Schären M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefan Schären M.D. .

Editor information

Editors and Affiliations

  1. Klinik für Wirbelsäulenchirurgie, SANA Krankenhaus Rummelsberg, Schwarzenbruck, 90593, Germany

    Uwe Vieweg

  2. Klinik für Orthopädie, Unfall- und, Wirbelsäulenchirurgie, EuromedClinic, Europa-Allee 1, Fürth, 90763, Germany

    Frank Grochulla

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Schären, S. (2012). Overview of Surgical Techniques and Implants. In: Vieweg, U., Grochulla, F. (eds) Manual of Spine Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-22682-3_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-22682-3_24

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-22681-6

  • Online ISBN: 978-3-642-22682-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation