• Pavlos Katonis, Stamatios A Papadakis, Spyros Galanakos, Ditran Paskou, Artan Bano, George Sapkas, and Alexander G Hadjipavlou.
• Department of Orthopaedics, Crete University, Medical School, Herakleion, Athens, Greece.
• J Spinal Disord Tech. 2011 Oct 1;24(7):415-20.

Study DesignRetrospective, consecutive patient series.ObjectiveTo quantify the risks and the complications associated with screw fixation devices of the cervical spine.Summary Of Background DataThe usefulness of lateral mass internal fixation has been well documented in the clinical setting. However, there is a paucity of studies examining the complications associated with these devices in a degenerative clinical setting.MethodsFrom 1999 to 2007, 225 consecutive patients underwent posterior cervical fixation using a screw-plate and polyaxial screw-rod implant systems. There were 105 women and 120 men (age range: 45 to 84 y; mean, 68 y). In all patients, the surgical indication was cervical spondylosis with myelopathy. Mean follow-up interval was 18 months (range: 12 to 72 mo). Screw position was evaluated by computed tomography scanning postoperatively in all patients. Clinical and radiographic outcome was assessed at each visit after surgery.ResultsIntraoperative complications include fracture of lateral mass in 27 screws placement and nerve irritation in 3 bicortical screws. Early complications include hematoma formation in 2 cases and C5 root palsy in 5 cases after spinal canal decompression. Late complications include pseudarthrosis in 6 cases and screw pull-out in 3 cases. There were no cases of spinal cord or vertebral artery injury, infections, deaths, or adjacent segment disease. All patients had radiographic union, and no patient developed mechanical implant failure requiring removal of instrumentation. Reoperation was required in 14 (6.2%) cases because of nerve injury, hematoma formation, pseudarthrosis, and screw pull-out.ConclusionsOur clinical findings indicate that lateral mass fixation can be used safely with minimal complications and low rate of morbidity for cervical myelopathy treatment.

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