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. 2013 Nov;22 Suppl 6(Suppl 6):S900-4.
doi: 10.1007/s00586-013-3015-y. Epub 2013 Sep 17.

Occipito-cervical fusion in post-traumatic instability of the upper cervical spine and cranio-cervical junction

Michele Cappuccio  1 , Federico De Iure, Luca Amendola, Stefania Paderni, Giuseppe Bosco
Affiliations

Occipito-cervical fusion in post-traumatic instability of the upper cervical spine and cranio-cervical junction

Michele Cappuccio et al. Eur Spine J. 2013 Nov.

Abstract

Introduction: Surgical management of upper cervical spine (UCS) unstable injuries may be challenging as the number of cases requiring this surgery collected in every single center is small. This retrospective study was conducted to analyze the radiographic and clinical results in 12 patients undergoing a posterior occipito-cervical fusion by a polyaxial screws-rod-plate system.

Methods: There were eight male and four female patients with a mean age of 73.7 years (range 32-89 years). Six patients presented neurologic deficits at admission. Six patients had sustained major trauma. The remaining six patients had suffered a minor trauma.

Results: Two patients died postoperatively in Intensive Care Unit. All surviving patients achieved solid fusion at 6 months. No surviving patient had neurological deterioration postoperatively. There were no instrumentation failures or revision required. Two patients suffered from superficial occipital wound infection.

Conclusions: Although the indication to occipito-cervical fusion decreased since the new C1-C2 posterior fixation techniques were described, it remains a valid and reliable option in UCS post-traumatic instability to be applied even in emergency especially in the elderly.

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Figures

Fig. 1
Fig. 1
(Case no. 9) C1–C2 fracture-dislocation with a reduction of the spinal canal >50 % in an 81-year-old man (a, b). Reduction and stabilization is achieved by posterior OCF (c)
Fig. 2
Fig. 2
(Case no. 7) C2–C3 fracture-dislocation through a calcified disk in a 72-year-old lady. Preoperative CT showing malalignment in lateral and AP reconstruction (a). Complete healing in correct alignment at 6 months CT (b) and X-rays (c)
See this image and copyright information in PMC

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