Posterior Subaxial Cervical Spine Screw Fixation: A Review of Techniques

Abstract

Study Design:A narrative literature review.Objectives:To review the surgical techniques of posterior screw fixation in the subaxial cervical spine.Methods:A broad literature review on the most common screw fixation techniques including lateral mass, pedicle, intralaminar and transfacet screws was performed on PubMed. The techniques and surgical nuances are summarized.Results:The following techniques were described in detail and presented with illustrative figures, including (1) lateral mass screw insertion: by Roy-Camille, Louis, Magerl, Anderson, An, Riew techniques and also a modified technique for C7 lateral mass fixation; (2) pedicle screw fixation technique as described by Abumi and also a freehand technique description; (3) intralaminar screw fixation; and finally, (4) transfacet screw fixation, as described by Takayasu, DalCanto, Klekamp, and Miyanji.Conclusions:Many different techniques of subaxial screw fixation were described and are available. To know the nuances of each one allows surgeons to choose the best option for each patient, improving the success of the fixation and decrease complications.

Predicting the loss of correction after isolated anterior stabilization in the surgical treatment of subaxial cervical dislocations

“…Декомпрессия спинного мозга достигается путем вправления вывиха любым из существующих закрытых или открытых способов, при этом восстанавливается клиренс позвоночного канала [8,26]. Согласно современным отечественным и зарубежным клиническим рекомендациям, после успешного вправления вывихов шейных позвонков, устранения деформации, восстановления клиренса позвоночного канала и декомпрессии спинного мозга необходимо осуществить либо переднюю [29,30], либо заднюю [32,31], либо комбинированную [8,[33][34][35] стабилизацию поврежденного сегмента позвоночника. Возникает вопрос о факторах, которые определяли бы прогноз успешности или неуспешности того или иного хирургического вмешательства.…”

Intraoperative surveillance of the vertebral artery using indocyanine green angiography and Doppler sonography in craniovertebral junction surgeries

“…A narrow C2 pedicle was considered present when the largest pedicle width was 4 mm or less, because the diameter of commonly used screws is 4.0 or 3.5 mm. 4,21 Additionally, when the patient's pathology is related to tumor, infection, rheumatoid arthritis (RA), congenital anomaly, or revision surgery, the surgeon may not be sure where the VA is located.…”

The Subaxial Cervical Pedicle Screw for Cervical Spine Diseases: The Review of Technical Developments and Complication Avoidance

“…In general, the VA passes anterior to the lateral mass of C7 into the transverse foramen at C6 and courses upward to the transverse foramen at C1. 8) A preoperative axial CT finding of thinning of the pedicle on one side indicates enlargement of the transverse foramen or invasion of the vertebral body, and magnetic resonance angiography or computed tomography angiography is needed to evaluate VA anomalies such as a tortuous course or unilateralpredominance. In patients with a VA anomaly or asymmetric unilateral dominance, surgeons should consider alternative safer techniques such as lateral mass screw insertion ( Fig.…”