Posterior Stabilization with Halifax Interlaminar Clamps in Unstable Cervical Spine Injuries

Fifty-two patients with unstable cervical spine injuries underwent operations between January 1, 1990 to June 30, 1997 in our institution and this is retrospective study on clinical results about these patients. Patients with cervical instability resulted from injury posterior column, being included in White's criteria, were treated with Hafifax interlaminar clamps for cervical instability. We followed up forty-two cases for more than one year. All of the forty- two cervical fixations showed immediate and long term stability and there were no neurological complication. Neu rologic improvements were seen in thirty three, but thirteen cases were unchanged. These results indicate that Halifax interlaminar clamps are consider to be a safe and effective method for posterior stabilization of va rious causes of cervical spine instability.

Application of C1-C3 Halifax Interlaminar Clamps in Addition to C1-C2 Cable Fixation

C1-C2 transarticular screw fixation has been a preferred method for the fixation of atlantoaxial subluxation caused by the rheumatoid arthritis or recurrent subluxation caused by postoperative non-union. However, it has required extensive occipitocervical fusion or rigid external orthoses such as halo brace after cable fixation especially when the patient has the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw. The author applied a pair of Halifax interlaminar clamps from C1 to C3 following the C1-C2 cable fixation in one patient with rheumatoid atlantoaxial subluxation and the other with recurrent subluxation after postoperative non-union. The prominent transverse foramen in both patients precluded the safe passage of the C1-C2 transarticular screw. Both patients were maintained in semirigid external orthoses by using philadelphia collar for 3 months after surgery. One has been doing well for 1 year and the other for 5 months following surgery. In conclusion, the application of the Halifax interlaminar clamps from C1 to C3 in addition to the C1-C2 cable fixation can be a useful alternative procedure circumventing extensive occipitocervical fusion for patients with the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw, thereby not sacrificing the motion between occiput and atlas.

Long-term Outcome of Posterior Cervical stabilization with Halifax Interlaminar Clamp

Posterior cervical fusion is still the procedure of choice in the cases of spinal instability caused by flexion injuries. Halifax interlaminar clamp system can be used whenever posterior cervical fusion is to be performed. Thirty-one consecutive patients were treated with Halifax interlaminar clamp for cervical instability from Jan. 1991 to Jan. 1995. We followed up all of the cases for more than one year. All of the twenty-six mid-and low-cervical fixations showed immediate and long-term stability and there were no neurological complications. Two cases among the five C1-2 fixations were failed due to loosening of clamps. Fifteen cases of mid-and low-cervical fixations showed facet sclerosis and interbody fusion on the plain X-ray films after more than one year.