OCCIPITOCERVICAL FIXATION IN NONTRAUMATIC UPPER CERVICAL-SPINE INSTABILITY

Ten patients requiring occipitocervical fixation were reviewed: five w ere unstable secondary to rheumatoid arthritis, one had Klippel-Feil, and four had neoplastic disease. Patients with nonneoplastic disease i mproved, having decreased pain, decreased paresthesias, and increased ambulation. Patients with neoplastic disease improved significantly af ter the surgery, but eventually died from different tumors. The techni que found to be most efficient was the placement of an intraoperativel y contoured Luque rectangle wired from the occiput to appropriate cerv ical spine levels.