Lateral mass plating in cervical spine injuries

ABSTRACT

In this study, the technique of lateral mass plating was used in the fixation of unstable cervical spine due to traumatic injuries in eight patients who had clinical and radiological evidence of instability. They were all injuries from C3 to C6 region. Seven patients were and remained neurologically intact and one patient had quadriplegia before and died one week after surgery as a result of complication of pulmonary embolism. All injuries were posterior ligamentous with subluxation due to unilateral or bilateral facetal injuries. Initially, stainless steel hardware was used, but titanium plates were used in the last two cases. There were no complications of nerve root or vertebral artery injury in the cases. One patient continued to have axial neck pain and C4 radiculopathy due to technical error and the patient refused surgery to revise his fusion. The technique has been appeared to be safe and effective for internal fixation of unstable cervical spine due to posterior ligamentous and facetal injuries. The technique required a complete understanding of the surgical anatomy and proper screw placement to avoid neurovascular injury