Skip Navigation LinksHome > March 1, 2005 - Volume 30 - Issue 5 > Occipitocervical Fixation: Long-Term Results
Spine:
doi: 10.1097/01.brs.0000154715.88911.ea
Cervical Spine

Occipitocervical Fixation: Long-Term Results

Deutsch, Harel MD; Haid, Regis W. Jr MD; Rodts, Gerald E. Jr MD; Mummaneni, Praveen V. MD

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Abstract

Study Design. The study is a retrospective review of 58 patients who underwent occipitocervical fusion between 1997 and 2001.

Objectives: Our objective is to study the clinical results after occipitocervical fixation with long-term follow-up and assess factors contributing to clinical success.

Methods: Data from patient charts, operative notes, physician office notes, and imaging studies were incorporated in the study. Myelopathy was assessed using a Nurick scale for preoperative and postoperative evaluation. Fusion was assessed using cervical plane films with flexion and extension views.

Results: Mean follow-up was 36 months, with all patients having a greater than 1-year follow-up. The most common pathology was congenital cranial settling (41%) followed by trauma (22%) and rheumatoid arthritis (17%). Myelopathy was the most common presentation (62%) followed by pain (28%). A successful fusion occurred in 48 out of 51 patients (94%). Symptoms improved in 86% of patients, whereas 35% improved 1 Nurick grade. Complications occurred in 30% of patients. The cervical wound infection rate was 5%. The rate of adjacent level degeneration was 7%. The mortality rate was 1.7%.

Conclusions: Occipitocervical instrumentation allows for very high fusion rates without the need for halo vest immobilization. All patients with successful fixation have pain resolution. Myelopathy improves in most patients, whereas one-third of patients demonstrate dramatic improvement.

© 2005 Lippincott Williams & Wilkins, Inc.

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