OUR EXPERIENCE WITH MAGERL’S MODIFIED TECHNIQUE FOR STABILIZATION OF SUBAXIAL CERVICAL SPINE

Dimitar Haritonov, Svetoslav Kalevski, Nikolay Peev

Abstract


Aim: There are different surgical techniques for massa lateralis screw instrumentation of subaxial cervical spine--those of Roy-Camille, Magerl, Anderson, and An. Each has different starting point and trajectorys of screw implantation.For each technique there is a potential risk to affect vascular and neural structures.In this paper we share our experience in using a modified Magerl's technique for stabilization of subaxial cervical spine.
Method:We present a retrospective study and clinical follow-up of 27 patients operated on the occasion of cervical injury that we have used the modified technique of Magerl. In 8 patients was carried and an anterior decompression and stabilization.
Results: In these patients was carried posterior or combined -- posterior and anterior stabilization. The posterior fixation was massa lateralis with this modified technique of Magerl with multiaxial screws. With this technique were inserted 160 multiaxial screws and the most common length of the implants were 108 mm (108 from 160 or 67.5%).
Conclusion: Based on world literature, experience and analysis of clinical cases, we believe that this modified technique for subaxial cervical fixation is effective (the pull-out strength approach to the strength of pedicle screw instrumentation) and is much safer.
Key words: Posterior subaxial instrumentation, Magerl's technique, suaxial instability.


Full Text:

PDF

References


Abumi K, Kaneda K. Pedicle screw fixation for nontraumatic lesions of the cervical spine. Spine. 1997; 22(16): 1853–63.

Abumi K, Kaneda K, Shono Y, Fujiya M. One-stage posterior decompression and reconstruction of the cervical spine by using pedicle screw fixation systems. J Neurosurg. 1999; 90 (1 Suppl): 19–26.

Anderson PA, Henley MB, Grady MS, Montesano PX, Winn HR. Posterior cervical arthrodesis with AO reconstruction plates and bone graft. Spine. 1991; 16(3 Suppl): S72–9.

Deen HG, Birch BD, Wharen RE, Reimer R. Lateral mass screw-rod fixation of the cervical spine: a prospective clinical series with 1-year followup. Spine J. 2003; 3 (6): 489–95.

Horgan MA, Kellogg JX, Chesnut RM. Posterior cervical arthrodesis and stabilization: an early report using a novel lateral mass screw and rod technique. Neurosurgery. 1999; 44 (6): 1267–71.

Jeanneret B, Magerl F, Ward EH, Ward JC. Posterior stabilization of the cervical spine with hook plates. Spine. 1991; 16 (3 Suppl): S56–63.

Gill K, Paschal S, Corin J, Ashman R, Bucholz RW. Posterior plating of the cervical spine. A biomechanical comparison of different posterior fusion techniques. Spine. 1988; 13 (7): 813–6.

Shapiro S, Snyder W, Kaufman K, Abel T. Outcome of 51 cases of unilateral locked cervical facets: interspinous braided cable for lateral mass plate fusion compared with interspinous wire and facet wiring with iliac crest. J Neurosurg. 1999; 91 (1 Suppl): 19–24.

Ulrich C, Arand M, Nothwang J. Internal fixation on the lower cervical spine —biomechanics and clinical practice of procedures and implants. Eur Spine J. 2001; 10(2): 88–100.

Roy-Camille R, Saillant G, Laville C, Benazet JP. Treatment of lower cervical spinal injuries — C3 to C7. Spine. 1992; 17(10 Suppl): S442–6.

Nazarian SM, Louis RP. Posterior internal fixation with screw plates in traumatic lesions of the cervical spine. Spine. 1991; 16 (3 Suppl): S64–S71.

An HS, Gordin R, Renner K. Anatomic considerations for plate-screw fixation of the cervical spine. Spine. 1991; 16(10 Suppl): S548–51.

Graham AW, Swank ML, Kinard RE, et al. Posterior cervical arthrodesis and stabilization with a lateral mass plate. Clinical and computed tomographic evaluation of lateral mass screw placement and associated complications. Spine. 1996; 21(3): 323–8 Šdiscussion 9¹.

Swank ML, Sutterlin III CE, Bossons CR, Dials BE. Rigid internal fixation with lateral mass plates in multilevel anterior and posterior reconstruction of the cervical spine. Spine. 1997; 22 (3): 274–82.

Heller JG, Silcox III DH, Sutterlin III CE. Complications of posterior cervical plating. Spine. 1995; 20 (22): 2442–8.

Mummaneni PV, Haid RW, Traynelis VC, et al. Posterior cervical fixation using a new polyaxial screw and rod system: technique and surgical results. Neurosurg Focus. 2002; 12 (1): E8.

Horn EM, Hott JS, Porter RW, Theodore N, Papadopoulos SM, Sonntag VK. Atlantoaxial stabilization with the use of C1–3 lateral mass screw fixation. Technical note. J Neurosurg Spine. 2006; 5 (2): 172–7.

Anderson PA, Budorick TE, Easton KB, Henley MB, Salciccioli GG. Failure of halo vest to prevent in vivo motion in patients with injured cervical spines. Spine. 1991; 16 (10 Suppl): S501–5.

Xu R, Haman SP, Ebraheim NA, Yeasting RA. The anatomic relation of lateral mass screws to the spinal nerves. A comparison of the Magerl, Anderson, and An techniques. Spine. 1999; 24 (19): 2057–61.

Barrey C, Mertens P, Jund J, Cotton F, Perrin G. Quantitative anatomic evaluation of cervical lateral mass fixation with a comparison of the Roy-Camille and the Magerl screw techniques. Spine. 2005; 30 (6): E140–7.

Chin KR, Eiszner JR, Roh JS, Bohlman HH. Use of spinous processes to determine drill trajectory during placement of lateral mass screws: a cadaveric analysis. J Spinal Disord Tech. 2006; 19 (1): 18–21.

Merola AA, Castro BA, Alongi PR, et al. Anatomic consideration for standard and modified techniques of cervical lateral mass screw placement. Spine J. 2002; 2 (6): 430–5.

Xu R, Ebraheim NA, Nadaud MC, Yeasting RA, Stanescu S. The location of the cervical nerve roots on the posterior aspect of the cervical spine. Spine. 1995; 20(21): 2267–71.

Pait TG, McAllister PV, Kaufman HH. Quadrant anatomy of the articular pillars (lateral cervicalmass) ofthecervicalspine. J Neurosurg. 1995; 82 (6): 1011–4.

Sekhon LH. Posterior cervical lateral mass screw fixation: analysis of 1026 consecutive screws in 143 patients. J Spinal Disord Tech. 2005; 18(4): 297–303.

Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K. Complications of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine. 2000; 25 (8): 962–9.

Abumi K, Shono Y, Taneichi H, Ito M, Kaneda K. Correction of cervical kyphosis using pedicle screw fixation systems. Spine. 1999; 24(22): 2389–96.

Albert TJ, Vacarro A. Postlaminectomy kyphosis. Spine 1998; 23(24): 2738–45.

Brodke DS, Bachus KN, Mohr RA, Nguyen BK. Segmental pedicle screw fixation or cross-links in multilevel lumbar constructs. Abiomechanical analysis. Spine J. 2001; 1(5): 373–9.

Dick JC, Zdeblick TA, Bartel BD, Kunz DN. Mechanical evaluation of cross-link designs in rigid pedicle screw systems. Spine. 1997; 22(4): 370–5.

Hart R, Hettwer W, Liu Q, Prem S. Mechanical stiffness of segmental versus nonsegmental pedicle screw constructs: the effect of cross-links. Spine. 2006; 31(2): E35–8.

Kast E, Mohr K, Richter HP, Börm W. Complications of transpedicular screw fixation in the cervical spine. Eur Spine J. 2006; 15(3): 327–34.

Kotani Y, Abumi K, Ito M, Minami A. Improved accuracy of computerassisted cervical pedicle screw insertion. J Neurosurg. 2003; 99(3 Suppl): 257–63.

Pateder DB, Carbone JJ. Lateral mass screw fixation for cervical spine trauma: associated complications and efficacy in maintaining alignment. Spine J. 2006; 6(1): 40–3.

Roche S, de Freitas DJ, Lenehan B, Street JT, McCabe JP. Posterior cervical screw placement without image guidance: a safe and reliable practice. J Spinal Disord Tech. 2006; 19(6): 383–8.

Valdevit A, Kambic HE, McLain RF. Torsional stability of cross-link configurations: a biomechanical analysis. Spine J. 2005; 5(4): 441–5.




DOI: http://dx.doi.org/10.24125/sanamed.v10i1.17

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 SANAMED

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.