Posterior Cervical Fixation with Nitinol Shape Memory Loop in the Anterior-Posterior Combined Approach for the Patients with Three Column Injury of the Cervical Spine : Preliminary Report

Yu, Dong Kun; Heo, Dong Hwa; Cho, Sung Min; Choi, Jong Hun; Sheen, Seung Hun; Cho, Yong Jun

Abstract

OBJECTIVE
The authors reviewed clinical and radiological outcomes in patients with three column injury of the cervical spine who had undergone posterior cervical fixation using Nitinol shape memory alloy loop in the anterior-posterior combined approach. MATERIALS: Nine patients were surgically treated with anterior cervical fusion using an iliac bone graft and dynamic plate-screw system, and the posterior cervical fixation using Nitinol shape memory loop (Davydov(TM)) at the same time. A retrospective review was performed. Clinical outcomes were assessed using the Frankel grading method. We reviewed the radiological parameters such as bony fusion rate, height of iliac bone graft strut, graft subsidence, cervical lordotic angle, and instrument related complication. RESULTS: Single-level fusion was performed in five patients, and two-level fusion in four. Solid bone fusion was presented in all cases after surgery. The mean height of graft strut was significantly decreased from 20.46+/-9.97 mm at immediate postoperative state to 18.87+/-8.60 mm at the final follow-up period (p<0.05). The mean cervical lordotic angle decreased from 13.83+/-11.84degrees to 11.37+/-6.03degrees at the immediate postoperative state but then, increased to 24.39+/-9.83degrees at the final follow-up period (p<0.05). There were no instrument related complications.
CONCLUSION
We suggest that the posterior cervical fixation using Nitinol shape memory alloy loop may be a simple and useful method, and be one of treatment options in anterior-posterior combined approach for the patients with the three column injury of the cervical spine.