Study design: Review article.
Objective: To review the indications, technical details, and complications of lateral mass and transfacet mass fixation methods.
Summary of background data: Potential advantages of rigid fixation in subaxial cervical spine have been defined as early mobilization, faster healing and fusion, and increased fusion rates. Lateral mass screw fixation has been the most popular fixation technique for posterior instrumentation. Transfacet screw fixation, on the other hand, is an alternative method less commonly used.
Methods: Narrative and review of the literature.
Results: Several different techniques aiming for the most safe and secure lateral mass screw fixation have been described by several different authors. Lateral mass screws provide rigid fixation and high fusion rates in patients with healthy bone. Complications are rare when patients' anatomy is well documented and proper technique is used. Transfacet screw fixation is another method less commonly used and with better biomechanical stability.
Conclusion: Lateral mass screw provides excellent 3-dimensional fixations from C3 to C7, and currently it is also the most commonly performed posterior fixation method.