J Korean Neurosurg Soc.  2012 Aug;52(2):114-119. 10.3340/jkns.2012.52.2.114.

Clinical Outcome of Modified Cervical Lateral Mass Screw Fixation Technique

• Kim SH
• Seo WD
• Kim KH
• Yeo HT
• Choi GH
• Kim DH

• KMID: 2190549
• DOI: http://doi.org/10.3340/jkns.2012.52.2.114

Abstract

OBJECTIVE
The purpose of this study was 1) to analyze clinically-executed cervical lateral mass screw fixation by the Kim's technique as suggested in the previous morphometric and cadaveric study and 2) to examine various complications and bicortical purchase that are important for b-one fusion.
METHODS
A retrospective study was done on the charts, operative records, radiographs, and clinical follow up of thirty-nine patients. One hundred and seventy-eight lateral mass screws were analyzed. The spinal nerve injury, violation of the facet joint, vertebral artery injury, and the bicortical purchases were examined at each lateral mass.
RESULTS
All thirty-nine patients received instrumentations with poly axial screws and rod systems, in which one hundred and seventy-eight screws in total. No vertebral artery injury or nerve root injury were observed. Sixteen facet joint violations were observed (9.0%). Bicortical purchases were achieved on one hundred and fifty-six (87.6%). Bone fusion was achieved in all patients.
CONCLUSION
The advantages of the Kim's technique are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known techniques. The Kim's technique can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

Keyword

Lateral mass screw; Cervical vertebra; Kim's technique; Complication

MeSH Terms

Cadaver
Follow-Up Studies
Humans
Retrospective Studies
Spinal Nerves
Vertebral Artery
Zygapophyseal Joint

Figure

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  Fig. 1 Intraoperative picture that shows how to determine the entry point of the screw and to adjust its trajectory using drill on both side.

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  Fig. 2 Postoperative plain X-ray. Lateral mass screw fixation was successfully established on C3 to C6 on both side using Kim's technique.

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  Fig. 3 Postoperative CT image. Each axial and sagittal image reveal the procedure was completed without facetal or transverse foramen violation.

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  Fig. 4 Postoperative CT image of C7 body. The lateral mass screw was not advanced enough on the left side. The arrow indicates the head of the screw contacts with lamina on medial side.

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