Results of Surgical Fixation of Occipitocervical Instability Using Polyaxial Plate/Rod System. Report of 14 Cases.

Abstract

Background Data: Occipitocervical junction instability has always been a challenging surgical problem owing to the unique anatomical and biomechanical characteristics of this region. Purpose: To detect the safety, efficacy and related complications using polyaxial screw-based constructs with rod / plate system for occipitocervical instability. Study design: This is a retrospective study for 14 patients underwent occipitocervical fusion for instability using polyaxial screw-based constructs with rod / plate system during the period from January 2007 to September 2011 in Cairo University Hospitals and Nasser Institute Hospital. Methods: Our study reviewed the surgical technique, the variety of instrumentation, the postoperative outcome, various complications and fusion rates related to this technique. Results: The 14 patients were 8 males and 6 females with a mean age of 44.9 years. Patients were operated upon with an average operative time of 91 minutes,and with average blood loss of 660 ml. The mean number of levels fused was 3.3 levels. The mean follow up period was 18 months. Clinical improvement occurred in 12 patients. Stability was evident in all the cases (100%), however bony fusion was reported in 12 patients (86%). Post operatively one case had infection at the operative bed which improved after 2 months.Conclusion: Surgical fusion and fixation of the occipitocervical junction using the new instrumentation system inspite technically demanding have proven clinical success and high fusion rate as well as biomechanical stability, with a very low rate of complications related to this procedure. (2012ESJ004)

Keywords

• fusion
• instability
• Instrumentation
• Occipitocervical