Posterior Cervical Region Research Articles

Variations of the rectus capitis posterior muscles: a case report.

Duplication, accessory slips, and division of the rectus capitis posterior muscles are rare anatomical variations. Here we report a case of unilateral doubling of rectus capitis posterior major, and doubling of rectus capitis posterior minor with an accessory slip originating from the spinous process of the second cervical vertebra. The gross anatomical characteristics, clinical significance, and relationship of suboccipital musculature to the cervical myodural bridge is discussed in this report. Knowledge of rectus capitis posterior muscle variations may be of interest to clinicians practicing surgical approaches to the posterior cervical region due to the close proximity of the variations to typical muscular and neurovascular structures of the suboccipital region and potential association with the cervical myodural bridge.

Ketorash: An underdiagnosed entity

Ketoacidosis-Induced Prurigo Pigmentosa is a rare, inflammatory disease characterized by pruritic, erythematous papules with a reticulate pattern on the torso and neck. It affects predominantly young adult Asian women with risk factors for metabolic ketosis, such as Diabetes Mellitus, anorexia nervosa, bariatric surgery and ketogenic diet. A 26-year-old female being treated for refractory focal frontal and generalized epilepsy with ketogenic diet for four months was consulted due to a three-month-long dermatosis which started in the anterior and posterior cervical region and progressed towards the dorsal midline area. Skin lesions were papular and erythematous, often merging with a vaguely reticulated pattern. These lesions were highly pruriginous and worsened during periods ofhigher ketonemia. Histological examination of a cutaneous biopsy sample was compatible with Ketorash. The patient suspended ketogenic diet and was medicated with topical erythromycin, with full resolution of the lesions and no recurrences after 8 months.

Diagnostic and therapeutic strategies for an evolving large jugal lipoma: a comprehensive case study

Lipoma, the most common benign mesenchymal neoplasm in soft tissues, is characterized by the localized growth of fat cells. In the oral cavity, lipomas typically present as well-defined, slow-growing, solitary submucosal nodules that are painless. They are generally easily diagnosed clinically, although there is a possibility of confusion with other neoplasms in the oral cavity In the cervicofacial area, lipomas account for 13% to 20% of cases, with the posterior cervical region being the most frequently involved. A 45-year-old male patient with an unremarkable medical history presented with a slowly evolving left jugal swelling that had been persistent for eight years. CT scan performed without any sign of infiltration. Surgical excision was done and histopathological exam has confirmed a lipoma. Infiltrative lipomas require particular attention, and it is advisable to remove them with a margin of healthy tissue to prevent recurrence. This strategy aims to ensure complete removal of the tumor and reduce the risk of its return. Keywords: Lipoma, Case report, Benign, Unesthetic, Sub-Saharan Africa.

Investigation of the Effect of Mobile and Immobile Regions on Fat Graft Viability: An Experimental Study in a New Model.

Fat grafts are widely used in plastic, aesthetic and reconstructive surgery. Their unpredictable resorption is their main disadvantage. A review of the literature shows that there is a lack of research on the effect of mobile and immobile regions on fat graft survival in fat graft applications. Our aim was to investigate the relationship of fat graft survival with mobile and immobile region in a new experimental model. Twenty-four male Wistar albino rats were randomly divided into two groups (n=12). Fat grafts were harvested from the right inguinal region of the rat. In Group 1, the fat graft was placed in the subcutaneous pouch formed in the scalp region of the rat. In Group 2, fat grafts were placed in the pouch formed in the posterior cervical region of the rat. At the end of 6weeks, the weights and histopathology of the fat grafts were evaluated. Histopathological examinations were performed in a blinded fashion. The weights of the fat grafts were found to be higher in Group 1. At the same time, histopathological examinations showed that vascular density was higher in Group 1. There was no statistically significant difference in other histopathological examinations. The mobile and immobile areas may have different effects on the survival of transplanted fat grafts. Sliding movement between muscle and skin in the mobile zone puts stress on the fat graft. In our study, the mobile site was shown to have a negative effect on the vascularity of the fat graft. It was observed that the vascular density was higher in the fat graft placed in the immobilised area. Further studies on the increase in vascularity can be carried out using the new experimental model we have created. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Exploring the Relationship Between Subcutaneous Fat Index and Neck Pain in Patients with Spinal Cervical Spondylosis: A Retrospective Cohort Study

Retrospective Cohort Study. This study measures the subcutaneous fat index (SFI) of the cervical spine in patients with spinal cervical spondylosis using cervical magnetic resonance imaging and explores its relationship with neck pain in patients with spinal cervical spondylosis. In this single-center retrospective study, 298 patients hospitalized for spinal cervical spondylosis between January and June 2021 were initially considered. After applying inclusion and exclusion criteria, 93 patients were enrolled. The cervical magnetic resonance imaging data for these patients were analyzed using A-Site software. The SFI was measured at the median sagittal plane on T2-weighted images. Patients were categorized into 2 groups based on their admission complaints: those with cervical pain and those without it. Differences between these groups were then statistically analyzed. The mean SFIs with standard deviations for the neck and non-neck pain groups were 36.4%±7.7% and 27.0%±7.9%, respectively, with a significant difference (P < 0.0001). The SFI was consistently higher across all neck segments in the neck pain group compared to the nonneck pain group (P < 0.05). The 2 groups had no statistically significant difference in the body mass index. The SFI provides a more precise assessment of muscle and fat distribution in the posterior cervical region than body mass index and is generally higher in patients with spinal cervical spondylosis who experience neck pain. These findings suggest the importance of early functional exercises postsurgery for potentially improving surgical outcomes in this patient population.

Management Outcomes of Lymphadenopathy among the Children

Background: Lymphadenopathy refers to the enlargement of lymph nodes due to various causes, and its appropriate management is crucial for optimal patient outcomes.&#x0D; Objective: To analyze the onset of lymphadenopathy (LAP) in children in terms of gender and age, explore its clinical manifestations and the specific lymph node areas affected, identify prevalent causes, and assess the outcomes of various treatment approaches.&#x0D; Patients and Methods: This cross-sectional study conducted between October 2021 and March 2023 at Rapareen Teaching Hospital for Children in Erbil City, which examined the lymphadenopathy in 40 children . The study included children aged 0-15 years with a lymphadenopathy diagnosis. Data collection involved recording demographic information, lymphadenopathy site and characteristics, clinical symptoms, antibiotic usage and response, reactive diagnoses, and treatment outcomes. Additional laboratory measurements were also taken. The collected data were analyzed using descriptive statistics, statistical tests, and logistic regression analysis. The study adhered to ethical principles, obtained informed consent, and ensured data confidentiality.&#x0D; Results: The mean age of the children was 3.397 ± (2.192) years. 23 (59%) children had a single lymphadenopathy, and 16 (41%) had multiple lymphadenopathies. The most common site of lymphadenopathy with a frequency of 10 (25%) was in the posterior cervical region, while 7 (17.5%) was observed in the submental area. 38 (95%) children received antibiotic treatment. Out of this number, 23 (60.5%) responded positively to the treatment, while 15 (39.5.5%) did not respond. &#x0D; Conclusion: The results of this study showed that in the patients who were treated with antibiotics, the drug was able to lead to some degree of recovery.

Management Outcomes of Lymphadenopathy among the Children

Background: Lymphadenopathy refers to the enlargement of lymph nodes due to various causes, and its appropriate management is crucial for optimal patient outcomes. Objective: To analyze the onset of lymphadenopathy (LAP) in children in terms of gender and age, explore its clinical manifestations and the specific lymph node areas affected, identify prevalent causes, and assess the outcomes of various treatment approaches. Patients and Methods: This cross-sectional study conducted between October 2021 and March 2023 at Rapareen Teaching Hospital for Children in Erbil City, which examined the lymphadenopathy in 40 children . The study included children aged 0-15 years with a lymphadenopathy diagnosis. Data collection involved recording demographic information, lymphadenopathy site and characteristics, clinical symptoms, antibiotic usage and response, reactive diagnoses, and treatment outcomes. Additional laboratory measurements were also taken. The collected data were analyzed using descriptive statistics, statistical tests, and logistic regression analysis. The study adhered to ethical principles, obtained informed consent, and ensured data confidentiality. Results: The mean age of the children was 3.397 ± (2.192) years. 23 (59%) children had a single lymphadenopathy, and 16 (41%) had multiple lymphadenopathies. The most common site of lymphadenopathy with a frequency of 10 (25%) was in the posterior cervical region, while 7 (17.5%) was observed in the submental area. 38 (95%) children received antibiotic treatment. Out of this number, 23 (60.5%) responded positively to the treatment, while 15 (39.5.5%) did not respond. Conclusion: The results of this study showed that in the patients who were treated with antibiotics, the drug was able to lead to some degree of recovery. Keywords: Lymphadenopathy; Lymph node; Management ,Children

Cobb Syndrome Associated with Spinal Cavernoma – Case Report

AbstractCobb syndrome, or cutaneomeningospinal angiomatosis, is a rare condition that affects young adults, and its etiology has not been completely elucidated. It is characterized by a cutaneous sign, or stigma, associated with spinal or intracranial malformations. The symptoms are quite diverse, but, in most cases, the disease presents motor deficit and pain. The present study reports the case of a 48-year-old female patient, who initially sought dermatological medical care for a single skin lesion in the posterior cervical region. During the excision, it was noticed that the lesion had contiguous behavior to the deep anatomical planes, thus requiring the evaluation of the neurosurgical team. The purpose of this report is to describe this rare disease, covering more details about diagnosis and therapy.

Frictional Lichenoid Dermatitis

A previously healthy 4-year-old boy presented with a rash on his elbows and knees that over 3 weeks became pruritic and expanded to the posterior cervical region and hands. It appeared during the summer, while frequently wearing a thermal suit. The patient had no systemic symptoms and none of his cohabitants had a rash. Skin examination revealed flesh-colored to mildly erythematous flat-topped papules on the extensor surfaces of the elbows and knees, posterior cervical region and the dorsum of the hands (Figure 1). The findings were compatible with the diagnosis of frictional lichenoid dermatitis, no further studies were performed and the patient was treated with topical hydrocortisone during 2 weeks, with improvement. Frictional lichenoid dermatitis is probably underdiagnosed and it is a benign and self-limited disease with typical clinical presentation, so it is important to recognize it as not to prescribe unnecessary workup and medication.

Surgical Removal of Cervical Extradural Cysts Using the Biportal Endoscopic Approach

Symptomatic intraspinal extradural cysts of the cervical spine are uncommon; however, they are usually treated using conventional posterior decompression. Biportal endoscopic surgery is widely used to treat degenerative cervical pathological conditions. This study presented an optimized surgical technique for a biportal endoscopic posterior approach for removal of cervical intraspinal extradural cysts that caused cervical radiculomyelopathy. A broad laminotomy was performed, which was wider than the outer contour of the cysts. The ligamentum flavum was detached from the bony margin and removed after an epidural dissection, and a dense adhesive tissue entrapped the extradural cysts. A spinal endoscope was placed close to the dissection plane and offered a high-resolution magnified view. The cyst capsule was safely dissected from the dura and removed en bloc without dural injury. Postoperatively, neurological deficits, including cervical myelopathy, radiating arm pain, and upper back pain improved in both patients. We successfully removed an extradural cervical cystic mass lesion by using a biportal endoscopic posterior cervical approach without complications. The biportal endoscopic approach may have advantages, such as minimizing trauma to the normal structures of the posterior cervical region, magnified endoscopic view, and early recovery after the surgery. Biportal endoscopy may be used as an alternative surgical treatment for symptomatic cervical intraspinal extradural cystic lesions.

Prevalence of trigeminocervical convergence mechanisms in episodic and chronic migraine.

Migraine pain location and trigeminocervical convergence have limited diagnostic value and have usually been assessed using non-standard verbal descriptors in a small number of centers. To use non-verbal descriptors of migraine pain location to determine the prevalence of trigeminocervical convergence mechanisms in patients with episodic and chronic migraine. In addition, we explored the factors associated with the presence of convergence. A multicenter study was carried out. The explicit pain location was explored by asking subjects to indicate, on an electronic form, three points on the anterolateral side and three points on the posterolateral side of the head and neck that represented the common locations of their migraine pain. We evaluated associations of the pain pattern with demographic and psychological features, comorbidities, lifestyle and other headache characteristics. 97 episodic and 113 chronic migraine patients were included. Convergence was present in 116 migraineurs (55%) who indicated dominance of pain in the posterior cervical region. This site was more often involved in the chronic migraine group (21 vs. 33%; p=0.034). The number of migrainous/altered sensitivity symptoms (OR=1.39; 95%CI 1.14-1.71) was associated with convergence independently of the chronification status. In this symptom group, there were statistical associations between convergence and vomiting (p=0.045), tactile allodynia (p<0.001), nuchal rigidity (p<0.001) and movement allodynia (p=0.031). Trigeminocervical convergence is common in migraineurs and, in practice, it might be found frequently in chronic migraineurs. Some features commonly found in this group, such as altered sensitivity symptoms, are associated with this phenomenon.

Kikuchi-Fujimoto disease (KFD): A Case Report

Abstract Kikuchi-Fujimoto disease (KFD) is a rare entity characterized by subacute necrotizing lymphadenopathy. Despite many studies in the literature, the cause of KFD remains uncertain. Young adults of Asian ancestry are most affected, but it has been reported worldwide. Clinically, KFD is characterized by lymphadenitis of one or more lymph nodes, predominantly in the posterior cervical region, fever, and leukopenia in up to 50% of cases. In this case report, we are presenting a case of Kikuchi-Fujimoto disease in a young Filipino lady. Keywords: Kikuchi-Fujimoto disease, KFD, Kikuchi disease, Acute necrotizing lymphadenopathy, Lymphadenitis.

Prurigo Pigmentosa Induced by the Ketogenic Diet

Prurigo pigmentosa, also called Nagashima disease or "keto-rash", is a rare inflammatory skin condition. The etiology is unknown, but conditions associated with ketosis (fasting, diabetes, postbariatric surgery) often accompany this rash. Clinical case: A 13-year-old patient with no significant pathological history, overweight, on a ketogenic diet, was consulted for maculopapular skin lesions and erythematous plaques, discretely pruritic, persistent, confluent, with centrifugal extension, located at the posterior cervical, axillary, later thoracic, epigastric and lumbar regions. Hematological, biochemical, and immunological investigations were normal. Initial therapy with medium potency topical corticosteroid and anti-H1 antihistamine was ineffective, instead, under treatment with doxycycline and giving up the ketogenic diet, the resolution of the lesions was obtained, residual hyperpigmentation with a reticulated pattern persisting. Conclusions: We present this case to highlight the increasingly common association between prurigo pigmentosa and the ketogenic diet. Dermatologists should identify the relationship between the timing of rash onset and resolution in relation to diet, with a view to early diagnosis and treatment with optimal patient outcomes.

Giant Thoracic Wall Lipoma Mimicking Plexiform Neurofibroma: A Case Report

Lipoma, a benign tumour of adipose tissue and mesenchymal origin, can occur anywhere in the body where normal fat deposits are present. Aside from the usual locations of the upper extremity, thigh, back, and shoulder, it is also seen very rarely in the posterior cervical region, face, and chest wall. Depending on the size, it is called a giant lipoma, i.e &gt;5 cm. To differentiate giant lipoma with other differentials like neurofibroma and liposarcoma, Fine Needle Aspiration Cytology (FNAC) is required to reach the definitive diagnosis and plan for the required surgical treatment. Here, a rare case of a 53-year-old male is reported, with chief complaints of swelling in front of his chest for the past 25 years. On evaluation, Magnetic Resonance Imaging (MRI) thorax reported a large, elongated, lobulated soft tissue mass in the subcutaneous plane of the anterior thorax. Under general anaesthesia, an elliptical incision was given and a complete portion of the mass was excised. Histopathological examination revealed, encapsulated adipose cells, capillaries, and connective tissue stroma, pathognomic of Lipoma. Postoperatively, there was haematoma formation, which was managed conservatively. In the evidence based system, chronology of approach for skin and soft tissue swelling need to be followed, which starts from FNAC followed by Computed Tomography (CT) and MRI.

Posterior Cervical Brown Fat and CXCL14 Levels in the First Year of Life: Sex Differences and Association With Adiposity.

Brown adipose tissue (BAT) is particularly abundant in neonates, but its association with measures of adiposity and metabolic health in early infancy is poorly delineated. Besides sustaining nonshivering thermogenesis, BAT secretes brown adipokines that act on systemic metabolism. The chemokine CXCL14 has been identified as a brown adipokine in experimental studies. To determine the relationships among BAT activity, adiposity, and circulating CXCL14 levels in the first year of life in girls and boys. Indices of fat accretion, circulating endocrine-metabolic parameters and serum CXCL14 levels were assessed longitudinally in a cohort of infants at birth and at 4 and 12 months. BAT activity was estimated using infrared thermography only at age 12 months.The main outcome measures were weight and length Z-scores, total and abdominal fat content (by dual X-ray absorptiometry), BAT activity at the posterior cervical and supraclavicular regions, serum levels of glucose, insulin, insulin-like growth factor-I, high-molecular-weight adiponectin, and CXCL14; CXCL14 transcript levels in neonatal BAT and liver. Posterior cervical BAT was more active in girls than in boys (P = .02). BAT activity was negatively associated with adiposity parameters only in girls. CXCL14 levels were higher in girls than in boys at age 12 months and correlated positively with the area of active posterior cervical BAT in girls. Neonatal BAT showed high CXCL14 gene expression levels. BAT activity and the levels of CXCL14-a potential surrogate of BAT activity-are sex specific in the first year of life. Posterior cervical BAT activity associates negatively with indices of adiposity only in girls.

Hubungan Durasi dan Postur Duduk terhadap Terjadinya Nyeri Leher Pada Mahasiswa Fakultas Kedokteran Universitas Udayana

Neck pain is felt in the posterior cervical region. Neck pain is placed fourth on the global burden of musculoskeletal at the World Health Organization and impacts a person’s productivity. The cause of neck pain itself cannot be clearly identified, but several risk factors are associated with neck pain. For example, age, occupation, sitting posture, duration of sitting, stress, body mass index, smoking history and gender. This study aims to determine the relationship between duration and sitting posture on the occurrence of neck pain in students of the Faculty of Medicine, Udayana University. This study is a cross-sectional analytic study that uses the NDI (Neck Disability Index) questionnaire. Neck pain intensity poin used to assess the occurrence of neck pain. This study had 206 research subjects. The data were analyzed using IBM SPSS statistic version 20. The chi-square test results showed that a significance value of 0.338 for the relation between sitting duration and the occurrence of neck pain, and a value of 0.949 for the relation between sitting posture and the occurrence of neck pain. From the analysis, it was found that there were no correlation between sitting duration and sitting posture on the occurrence of neck pain in students of the Faculty of Medicine, University of Udayana. It is necessary to do further research on other factors that can cause neck pain in students.&#x0D; Keywords : neck pain, sitting duration, sitting posture, Neck Disability Index

Fibromatoses of Head and Neck: Case Series and Literature Review.

ObjectiveThe objective of this study was to retrospectively review clinical data, management protocols, and clinical outcomes of patients with fibromatoses of head and neck region treated at our tertiary care center.MethodsWe retrospectively reviewed the medical records of 11 patients with confirmed histopathological diagnosis of fibromatosis registered in the Department of Head and Neck Surgery at Tata Memorial Centre, India, between 2009 and 2019. Various clinical and pathological features and treatment modalities were evaluated.ResultsAge at diagnosis ranged between 18 and 74 years, with a median age of 36 years. The female-to-male ratio was 5:6. Supraclavicular fossa (n=4) was the most common subsite of origin in the neck (n=8). The lateral (n=2) and posterior cervical regions (n=2) were other common neck subsites. Less commonly involved sites were the mandible (n=1), maxilla (n=1), and thyroid (n=1). A total of eight patients underwent surgery at other centers before being referred to us for further management. Out of a total 11 patients, nine patients had unresectable disease at presentation. Six of the patients with unresectable disease received a combination of weekly doses of vinblastine 6 mg/m2 and methotrexate 30 mg/m2 for a median duration of 6 months (range 6–18 months) followed by hormonal therapy with tamoxifen. Three patients received metronomic chemotherapy followed by hormonal therapy. One treatment-naive patient with fibromatosis of posterior cervical (suboccipital) region underwent R2 resection (excision of bulk of the tumor with preservation of critical structures) at our center along with adjuvant radiotherapy. One pregnant patient reported to us after undergoing surgery outside and defaulting radiotherapy. During median follow-up of 29 months (range 1–77 months), six patients had stable disease, and four patients had disease reduction. Disease progression was seen in one patient. The two-year progression-free survival (PFS) was 90% (95% CI 70%–100%).ConclusionGross residual resection (R2) was the mainstay of surgical treatment in our series, as obtaining clear surgical margins is seldom possible in these locally aggressive tumors. Radiotherapy, chemotherapy, and hormonal therapy are the other preferred and more conservative treatment modalities. The goal of surgery should be preserving function with minimal or no morbidity. As fibromatoses in the head and neck region are extremely rare, their treatment awaits the development of standard treatment protocols.

A Case Report of Anesthetic Management of a Large Tumor of the Nape of Neck in a Child

Large tumors of the head-and-neck region pose a challenge for the anesthetist, as often the anatomy gets disturbed in the area leading to difficulty in the airway management. Here, we report the case of a 2-year-old child with small round cell sarcoma of the neck with a 20 cm × 30 cm mass over the nape of the neck, extending from the occipital protuberance to C7 level and from the lateral margin of one sternocleidomastoid to the other, who was posted for subtotal excision of the swelling over the occipital and posterior cervical region under general anesthesia. The airway management was sought by introducing fiberoptic bronchoscope, and an endotracheal (ET) tube insertion was attempted which failed even after multiple attempts. Hence, a laryngeal mask airway (LMA) was inserted through which bronchoscope and ET tubes (ETTs) were inserted and airway was secured. Anesthesia was maintained with isoflurane and 0.1 mg/kg of atracurium and adequate opioids were given for analgesia. Surgeons described the tumor tissue to have brain tissue like consistency which caused difficulty in catching the bleeding vessels, and hence, there was massive intraoperative blood loss. Eventually, the child recovered well in the postoperative period and was discharged after a few weeks. Through our experience, we would like to suggest that pediatric anesthesiologists plan for fiberoptic intubation through the LMA as the first intubation attempt in a child with a potentially difficult airway, using two ETT's secured through a cut ETT connector. We would also like to highlight the importance of preparedness to handle massive blood loss in a round cell sarcoma.

Primary Epstein\u2013Barr virus infection shortly after primary Cytomegalovirus infection: a case report

BackgroundInfectious mononucleosis (IM) and mononucleosis-like illnesses are common viral infectious diseases which are often accompanied by a high fever, pharyngitis and lymphadenopathy in adults, although such infection in childhood is generally subclinical. Most cases of IM are caused by the Epstein–Barr virus (EBV) or Cytomegalovirus (CMV). However, it is difficult to diagnose IM only with subjective symptoms, and thus EBV and CMV are nearly indistinguishable in clinical practice.Case presentationA 20-year-old healthy Japanese woman had a 2-day history of high fever and consulted us. She had sex for the first time 6 months earlier. Her virus antibodies showed that she was infected with primary CMV. About 5 months later, she again experienced high fever and lymph node enlargement at the posterior cervical region. Her virus antibodies showed that she was infected with primary EBV at that time.ConclusionHerein, we report a healthy adult Japanese woman with primary EBV infection relatively soon after primary CMV infection. It is very interesting to compare the symptoms and/or clinical data after EBV and CMV infection in the same patient within a short period of time. Our patient was diagnosed based only on subjective symptoms, physical examination and laboratory data, without tests of such virus-related antibodies. Therefore, clinicians should bear in mind that primary EBV infection and/or primary CMV infection is possible when patients have symptoms such as high fever, pharyngitis and lymphadenopathy, even in healthy adults.

A new concept of motion preservation surgery of the cervical spine: PEEK rods for the posterior cervical region.

Laminectomy may cause kyphotic postoperative deformity in the cervical region leading to segmental instability over time. Laminoplasty may be an alternative procedure to laminectomy, as it protects the spine against post-laminectomy kyphosis; however, similar to laminectomy, laminoplasty may cause sagittal plane deformities by destructing or weakening the dorsal tension band. Using finite element analysis (FE), we attempted to determine whether a posterior motion preservation system (PEEK posterior rod system concept) could overcome the postoperative complications of laminectomy and laminoplasty and eliminate the side effects of rigid posterior stabilization in the cervical region. We compared PEEK rods in four different diameters with a titanium rod for posterior cervical fixation. The present study may lead to motion preservation systems of the cervical vertebra. When PEEK rod is compared with titanium rod, considerable increase in range of motion is observed. PEEK rod-lateral mass screw instrumentation systems may be useful in motion preservation surgery of the posterior cervical region.