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J Neurol Surg A Cent Eur Neurosurg 2022; 83(03): 231-235
DOI: 10.1055/s-0041-1728767
Original Article

Versatile Usage of the Modified Lateral Mass Screw as an Alternative to Cervical Pedicle Screw Fixation

Moon-Kyu Kim
1   Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
,
Jung-Jae Lee
1   Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
,
Su-Hee Cho
1   Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
,
Dai-Soon Kwak 
2   Catholic Institute for Applied Anatomy / Department of Anatomy, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Abstract

Objective Posterior subaxial cervical screw fixation is commonly performed using the cervical pedicle screws (CPS) and lateral mass screws (LMS); however, their compatibility is low. Modified lateral mass screws (mLMS, also called paravertebral foramen screw) fixation was introduced as a salvage technique for LMS fixation and has features of both LMS and CPS techniques. In the present study, the use of mLMS as an alternative to CPS was analyzed based on clinical results.

Methods Seventy-eight screws (38 CPSs and 40 mLMSs) were inserted into 12 patients. The misplacement of the screws was evaluated by computed tomography (CT). The failure of instrumentation and instability were evaluated using plain radiographs.

Results The total number of CPS misplacements was 3 (10.5%); however, neurologic complications were not observed. mLMSs were used in the middle segments of the fusion in 10 patients and 2 patients had mLMS fixation for single-level fusion. An additional bridging implant was not required for connecting both CPSs and mLMSs. Instability was not observed during the observation period (4–51 months). Complete fusion was seen in 10 patients.

Conclusions The alternative mLMS fixation can decrease the risk of screw misplacement compared with CPS fixation alone and achieves adequate stability leading to fusion.

Keywords

paravertebral foramen screw - modified lateral mass screw - cervical pedicle screw - lateral mass screw - subaxial - cervical - salvage technique


Publication History

Received: 14 June 2020

Accepted: 26 November 2020

Article published online:
30 June 2021

© 2021. Thieme. All rights reserved.

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