COMPLICATIONS OF POSTERIOR ARTICULAR MASS PLATE FIXATION OF THE SUBAXIAL CERVICAL-SPINE IN 43 CONSECUTIVE PATIENTS

Study Design. A retrospective study evaluating the complications in 43 consecutive patients treated with posterior lateral mass plate fixati on of the subaxial cervical spine. Objectives. To determine the surgic al complications of applying posterior lateral mass plates, to correla te complication rate with surgical technique, and to determine fusion rate. Summary of Background Data. Posterior cervical plate stabilizati on is a viable alternative to more traditional wiring techniques. Adva ntages include superior internal stability and no requirement for inta ct posterior spinal elements. Methods. Records of 43 consecutive patie nts who underwent posterior articular mass plate fixation were indepen dently reviewed to identify associated complications. The average foll ow-up was 25 months (range, 1 to 63 months). The most common indicatio ns for surgery were posttraumatic instability (n = 22) and instability after multilevel laminectomy (n = 14). Four patients had difficult sp inal disorders requiring a combined anterior and posterior approach. R esults. Two hundred eighty-one screws were inserted in the cervical sp ine (average, 7 screws per patient). There were no complications assoc iated with placement of the screws (i.e., root injury or vertebral art ery injury). Complications included two cases in which patients had su perficial wound infections and one in which the patient had a spinal e pidural hematoma requiring evacuation, In one patient, hardware failur e required an anterior approach to correct a progressive angulation. C onclusions. With the authors' surgical technique, lateral mass plate f ixation is safe and effective. There were no nerve root or vertebral a rtery injuries.