Lateral mass screw fixation in cervical spine injury.

Lal Rehman,Raza Rizvi,Iram Bukhari,Ali Afzal

doi:10.12669/pjms.336.12947

Lal Rehman, Raza Rizvi

Open Access

https://doi.org/10.12669/pjms.336.12947

Copy DOI

Abstract

Objective:To determine clinical outcome in patients with cervical injury after lateral mass screws fixation in a tertiary care hospital.Methods:This study included 88 patients, with cervical injury confirmed radiologically. Patients <12 or >70 years, with traumatic discs, cord compression without subluxation and previously operated on cervical spine were excluded from this study. All patients underwent fixation with lateral mass screws through posterior approach under fluoroscopic guidance. Frankel grading was used to assess the clinical status of these patients pre-operatively & post-operatively.Results:There were 60(68.18%) males and 28(31.8%) females. The ages varied from 18 to 55 years with a mean of 32 yrs ± 8 yrs. The most common level of injury was C5-C6 in 46(52%) patients. According to Frankel grading system, 35 (39.8%) patients were placed in Grade A, 15(17.05%) in Grade B, 22(25%) in Grade C, 12 (13.6%) in Grade D, four (4.5%) in Grade E on admission. Postoperatively, 16 (18.2%) patients were placed in Grade A, 23 (26.1%) in Grade B, eight (9.1%) in Grade C, nine (10.2%) in Grade D and 26(29.6%) patients in Grade E with an overall improvement in neurological function in 51(58%) and power in 37(42%) patients. The major complications encountered were respiratory infections in 10(11.36%) and wound infection in four (4.5%) while eight (9.1%) patients expired.Conclusion:Lateral mass screws technique is a safe and effective method for cervical fixation after proper reduction.

Highlights

Cervical spine injury is very common; the reason ascribed being an increased mobility of cervical spine, making it susceptible to trauma & variety of degenerative diseases.[1]
Cervical cord compression leads to weakness in all four limbs with MRI being the investigation of choice
Lateral mass screw fixation (LSF) with plates or rods has become the standard method for posterior cervical spine fixation and stability.[2]

Summary

INTRODUCTION

Cervical spine injury is very common; the reason ascribed being an increased mobility of cervical spine, making it susceptible to trauma & variety of degenerative diseases.[1]. Lateral mass screw fixation (LSF) with plates or rods has become the standard method for posterior cervical spine fixation and stability.[2]. Complete neurological injury - No motor or sensory function detected below level of lesion. Nonfunctional - Some voluntary motor function preserved below level of lesion but too weak to serve any useful purpose, sensation may or may not be preserved. Most surgeons believe the LSF techniques are optimum methods for reconstructing the stability of the cervical spine, following decompressive surgery.[3,4] Despite its ease of application and better biomechanical stability, when compared with other techniques, the main risk remains that of violating the spinal nerve root, vertebral artery, and/or facet joint.[5,6] The rationale of this study was to describe the safety profile and effectiveness of such system when used in stabilizing the cervical spine

METHODS

RESULTS

DISCUSSION