Damages of the cranio-vertebral junction include bone and ligamentous structures. Due to the unique design of the C0-C1-C2 complex and biomechanical properties, they represent a major surgical challenge. Treatment of damage to this area involves decompression of nerve structures with simultaneous occipito-cervical fixation from posterior access.
Aim: The aim of the study was to analyze patients operated on due to damage to the cranio-vertebral junction in 2009-2018.
Materials and methods: Medical documentation of 78 patients was analyzed in which occipito-cervical stabilization was performed due to damages in the C0-C1-C2, in the period 2009-2018 in the Department of Neuroortopedics Mazovian Rehabilitation Center STOCER. Demographic data, ie age and sex of patients, causes of C0-C1-C2 damage, perioperative complications, duration of surgery, time of hospitalization and perioperative blood loss were assessed in the study. The operating result was evaluated based on the bone fusion obtained.
Results: The occipital-cervical stabilization operations constituted on average 0.96% of all spinal surgery using implants. The most common indications for surgical treatment were injuries, especially in men (35.9%) and the consequences of rheumatoid arthritis, especially in women (29.5%). There were 37 females from 29 to 77 years (mean 54+/-25) and 41 men from 21 to 71 years (mean 53+/-23). The highest number of procedures was performed without laminectomy (53.8%) and in the C1 region (38.5%). The number of observed complications after the performed procedures was lower than in the reported literature, with surgical site infections occurring in 2.6% of cases.
Conclusions: Based on the analysis, it can be concluded that the accepted surgical procedure with the use of spine implants in patients with damage to the cranio-cervical junction was justified and the procedures performed correctly. A small number of complications indicates that the implemented procedure in the perioperative period is appropriate and ensures the patient's safety.
Keywords: damage of the cranio-verebral junction; spinal implant.
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