Posterior fixation of subaxial injuries using polyaxial screws

Design: a retrospective analysis. Purpose. To analyze the experience of using posterior screw fixation for subaxial injuries of cervical spine. Materials and Methods. The study based on the data of diagnosis and treatment of 32 patients with subaxial injuries treated in the Department of Neurosurgery of the Ilizarov Center within the period of 2010-2014 who underwent posterior screw fixation over the lateral mass, as well as interlaminar (translaminar) fixation - with implantation of 178 screws. Magerl and Roy-Camille technique combination used. Different options of stabilization applied: posterior bilateral, posterior unilateral, combined (anterior and posterior). Results. Follow-up of the patients was from six (6) months to three (3) years. There were no intraoperative complications due to the screw insertion (vertebral artery and nerve root damages). Intraoperative blood loss amounted from 100 ml to 600 ml (mean: 175±10 ml). The pain syndrome in the zone of surgical intervention eliminated completely within up to four (4) weeks after performing fixation in all patients. The degree of movement limitation corresponded to the level and number of fixed vertebral motion segments (VMS). The completeness of social adaptation depended on the presence and extent of the damage of the spinal cord and nerve roots and, accordingly, on the manifestation of neurological disorders. Conclusion. Posterior screw fixation in the subaxial area is an efficient way of stabilization for multicolumn damages. The technique of fixation over the lateral mass is the most common and safe one.