Cervical decompressive laminectomy and lateral mass screw-rod arthrodesis: surgical experience and analytical review of 4120 consecutive screws

Abstract

Background

Cervical decompressive laminectomy with lateral mass arthrodesis is a common neurosurgical procedure used to address a variety of cervical spine pathologies.

Purpose

This study aimed to determine the safety and efficacy of this neurosurgical procedure using the Anderson–Sekhon technique for screw trajectory.

Methods

The study retrospectively reviewed all clinical and radiological indicators for patients who underwent lateral mass arthrodesis between December 2005 and December 2017. All patients underwent polyaxial screw-rod implants using the Anderson–Sekhon technique for screw trajectory. It additionally reported all intra- and post-operative complications, along with short- and long-term outcomes for these patients. The follow-up period ranged from 2 months to 10 years.

Results

The study evaluated 695 patients who received a total of 4120 lateral mass screws. This is considered the largest reported case series up to date. No patients had neuro-vascular injuries. The main complications included 51 (7.3%) cases of screw malposition, as when the screw had breached either of foramen transversarium, neural foramen, or the facet joint; 39 (5.6%) cases of lateral mass breakdown; 29 (4.2%) cases of C5 root pain which has subsided overtime; 22 (3.2%) of incidental durotomy; and 18 (2.6%) cases of postoperative wound infection. There were only 3 cases of screw pullout leading to a stability rate of 99.5%. Most cases demonstrated very good to excellent outcomes on both short- and long-term follow-up.

Conclusions

Cervical decompressive laminectomy with lateral mass arthrodesis is a safe and effective technique for the management of different cervical spine pathologies, which results in favourable short- and long-term outcomes.

Keywords:

• Lateral mass fixation
• biomechanics
• laminectomy
• subaxial
• outcome

Disclosure statement

No potential conflict of interest was reported by the author(s).