J Korean Soc Spine Surg.  2004 Jun;11(2):121-124. 10.4184/jkss.2004.11.2.121.

Double Plate Occipitocervical Fusion After Failed Posterior Fusion C 1-2 With Wiring

• Lee KY
• Lee MJ
• Kim W

• KMID: 2097819
• DOI: http://doi.org/10.4184/jkss.2004.11.2.121

Abstract

A 31-year-old female complained of neck pain and limitation in neck motion. She had a 3 month history of treatment with Halovest at another hospital for a fracture of the odontoid process due to a car accident. The patient complained of persistent pain and limitation in neck motion following the cessation of Halovest. A dynamic radiograph demonstrated instability on C1-2 and she underwent a posterior cervical fusion with wiring. A wound infection developed, and loosening of the wire and lysis of the posterior arch at C1-2 were seen on a follow up plain radiograph 2 months postoperatively. She was transferred to our hospital where she underwent occipitocervical fusion with a double plate after control of the infection. There were rigid fixations of the plate and bone union on a follow up radiograph 24 months postoperatively.

Keyword

Mesenchymal stem cell; disc cell; TGF-b1; adenovirus; gene therapy

MeSH Terms

Adenoviridae
Adult
Female
Follow-Up Studies
Genetic Therapy
Humans
Mesenchymal Stromal Cells
Neck
Neck Pain
Odontoid Process
Wound Infection

Figure

• 

  Fig. 1. (A, B) Dynamic view of C-spine shows wire loosening, posterior arch lysis and severe instability

• 

  Fig. 2. (A) Immediate postoperative lateral radiograph shows double plate insertion with autologus bone graft after wire remove (B) Lateral radiograph at postoperative 24th month shows bone union and rigid fixation

Reference

1). Carlson GD, Bohlman HH. Surgical techniques for occiput to C2 arthrodesis. dillin WH, Simeone FA, editors. Posterior cervical spine surgery. 3rd ed.Philadelphia: p. 41. 1998.

2). Sasso RC, Jeanneret B, Fischer K, Magerl F. Occipitocervical fusion with posterior plate and screw instrumentation. Spine. 1994; 19:2264–2268.

3). Smith MD, Anderson P, Grady MS. Occipit oce rvical arthrodesis using contoured plate fixation. Spine. 1993; 18:1984–1990.

4). Elia M, Mazzara JT, Fielding JW. Onlay technique for occipitocervical fusion. Clin Orthop. 1992; 280:170–174.

5). Newman P, Sweetman R. Occipitocervical fusion: an operative technique and indications. J Bone Joint Surg. 1969; 51B:423–431.

6). Wertheim SB, Bohlman HH. Occipitocervical fusion: indications, techniques, and long-term results in 13 patients. J Bone Joint Surg. 1987; 69A:833–836.

7). Clark CR, Goetz DD, Menezes AH. Arthrodesis of the cervical spine in rheumatoid arthritis. J Bone Joint Surg. 1989; 71A:381–392.

8). Clark CR, Keggi KJ, Panajabi MM. Methylmethacry -late stabilization of the cervical spine. J Bone Joint Surg. 1984; 66A:40–46.

9). MaKenzie AI, Uttley D, Marsh HT, Bell BA. Craniocervical stabilization using Luque/Hartshill rectangles. Neu-rosergery. 1990; 26:32–36.

10). Malcolm GP, Ransford JR, Crockard HA. Treatment of non-rheumatoid occipitocervical instability. internal fixation with the Hartshill-Ransford loop. J Bone Joint Surg. 1994; 76B:357–366.

11). Takada T, Shono T, et al. Posterior occipitocervical reconstruction using cervical pedicle screws and plate-rod systems. Spine. 1999; 24:1425–1434.

12). Cahill DG. Posterior occipitocervical reconstruction using cervical pedicle screws and plate-rod systems. Spine. 2000; 25:1318.

13). Heller JG, Sillcox III DH, Sutterlin III CE. Complication of posterior cervical plating. Spine. 1995; 20:2442–2448.

14). Lieberman IH, Webb JK. Occipitocervical fusion using posterior titanium plate. Eur Spine J. 1998; 7:308–312.

15). Bradford LC, Panayiotis JP, Patricia GN, et al. Biomechanical evalution of new posterior occipitocervical instrumentation system. Clin Orthop. 2003; 411:103–115.