Clinical And Radiographic Evaluation of Posterior Cervical Arthrodesis and Stabilization Using Lateral Mass Screw and Rod at Alert Hospital,Addis Ababa, Ethiopia
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Date
2024-10-19
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Addis Ababa University
Abstract
Background: Lateral mass screw and rod fixation is the most practiced instrumentation for posterior cervical arthrodesis and stabilization for indication of cervical instability, trauma, neoplasm, decompression, and deformity correction. There is paucity of data in clinical and radiologic evaluation of Lateral mass screw and rod fixation especially in our setup.
Objective: Clinical and radiographic evaluation of posterior cervical arthrodesis and stabilization using lateral mass screw and rod fixation.
Method: Single center retrospective cross-sectional study of lateral mass screw and rod fixation from September 2019 up to September 2024 was evaluated with clinical and radiographic parameters. Sixty six patients were evaluated using structured questionnaire. Clinical parameters including Demographics and Neurological Status in trauma assessed by ASIA score, Functional Assessment in degenerative conditions by (mJOA), Radiographic Evaluation (computed tomography and dynamic x-ray) of 325 lateral mass screws inserted on 66 patients evaluated. Complications and Adverse Events (Infection, hardware failure, neurologic status, vascular incidents,) were assed from patient chart and radiology archive.
Result : The age of patients ranged from 16 up to 75 with mean age of 40.1yr and 84.9% within age of 20 up to 60. Male account for 84.8% and 15.2% are female. Post-traumatic indications accounted for 92.4% of cases, with fracture dislocations observed at C4/C5 (28.8%), C5/C6 (25.8%), C6/C7 (16%), and C4/5 (10.8%).Unilateral locked facet in 4.5% and floating lateral mass in 6%. Total of 325 screws inserted of which 110,79, 75, 57are at C5,C4,C6,C3 respectively in descending order. There was neither postoperative neurologic worsening nor improvement in the immediate postoperative ASIA score. Inadvertent Dural tear 3% articular joint violation in 1.9% and one patient had hardware failure on immediate postop period from loosening of screw nuts with dislodged rod. The postoperative rate of surgical site infection is 6%. Postoperative follow up ASIA score is significantly associated with preoperative ASIA score with Likelihood ratio and fishers exact test P value
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CERVICAL ARTHRODESIS AND STABILIZATION USING LATERAL