Clinical Outcome of Dorsal Cervical C1-C2 Fusion Using C1 Lateral Mass Screws, C2 Lamina Screws, and Interarcual Bone Graft Technique

J Neurol Surg A Cent Eur Neurosurg. 2020 May;81(3):200-206. doi: 10.1055/s-0038-1677519. Epub 2019 Nov 19.

Abstract

Aims: To evaluate the clinical and radiologic results of patients treated with dorsal cervical C1-C2 fusion using C1 lateral mass screws, C2 lamina screws, and interarcual bone graft.

Methods: We retrospectively analyzed the clinical and radiologic results of eight patients treated from 2011 to 2016. Neck pain, neurologic deficits, use of analgesics, vertebral artery injury, C2 root injury, radiologic fusion rate, malposition of screws, and implant failure were examined on day 3 and at 3 and 12 months postoperatively.

Results: One patient required revision surgery for a right-sided medial cutout of a lamina screw. None of the patients had vascular or neurologic complications. All patients were pain free and had ceased all analgesic therapy at the first follow-up examination. At the 1-year follow-up there were no complaints of neck pain, no radiologic signs of implant failure were found, and a bony union between C1 and C2 was present in all patients.

Conclusion: Dorsal cervical C1-C2 fusion using C1 lateral mass screws, C2 lamina screws, and interarcual bone graft are less common techniques, although they can be used safely and demonstrated excellent clinical results with regard to pain relief and a high fusion rate. The technique is an ideal alternative when other techniques are not safe for anatomical reasons.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atlanto-Axial Joint / surgery*
  • Bone Screws*
  • Bone Transplantation*
  • Female
  • Humans
  • Joint Instability / diagnostic imaging
  • Joint Instability / etiology
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Neck Pain / etiology
  • Reoperation
  • Retrospective Studies
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / etiology
  • Spinal Diseases / surgery*
  • Spinal Fusion / instrumentation
  • Spinal Fusion / methods*
  • Treatment Outcome