Transfacet screw placement for posterior fixation of C-7: Technical note

Eric M. Horn, Nicholas Theodore, Neil R. Crawford, Nicholas C. Bambakidis, Volker K.H. Sonntag

Research output: Contribution to journalArticlepeer-review

Abstract

Object. Lateral mass screws are traditionally used to fixate the subaxial cervical spine, while pedicle screws are used in the thoracic spine. Lateral mass fixation at C-7 is challenging due to thin facets, and placing pedicle screws is difficult due to the narrow pedicles. The authors describe their clinical experience with a novel technique for transfacet screw placement for fixation at C-7. Methods. A retrospective chart review was undertaken in all patients who underwent transfacet screw placement at C-7. The technique of screw insertion was the same for each patient. Polyaxial screws between 8- and 10-mm-long were used in each case and placed through the facet from a perpendicular orientation. Postoperative radiography and clinical follow-up were analyzed for aberrant screw placement or construct failure. Results. Ten patients underwent C-7 transfacet screw placement between June 2006 and March 2007. In all but 1 patient screws were placed bilaterally, and the construct lengths ranged from C-3 to T-5. One patient with a unilateral screw had a prior facet fracture that precluded bilateral screw placement. There were no intraoperative complications or screw failures in these patients. After an average of 6 months of follow-up there were no hardware failures, and all patients showed excellent alignment. Conclusions. The authors present the first clinical demonstration of a novel technique of posterior transfacet screw placement at C-7. These results provide evidence that this technique is safe to perform and adds stability to cervicothoracic fixation.

Original languageEnglish (US)
Pages (from-to)200-206
Number of pages7
JournalJournal of Neurosurgery: Spine
Volume9
Issue number2
DOIs
StatePublished - Aug 1 2008
Externally publishedYes

Keywords

  • Cervical fusion
  • Lateral mass
  • Spinal fixation
  • Spine trauma

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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