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Spinous process screw fixation: A salvage technique in sub-axial cervical spinal instrumentation.

World Neurosurgery 2021 July 20
OBJECTIVE: To evaluate the feasibility and efficacy of spinous process screws (SPS) in sub-axial cervical fixation.

METHODS: A retrospective study was conducted on seven patients receiving posterior cervical instrumentation for sub-axial fracture dislocation or atlantoaxial dislocation from 2014 to 2015. Additionally, a biomechanical test was performed on seven fresh-frozen cadaveric spine samples (from the occiput to C7) from healthy human subjects with no history of spinal trauma. And lastly, the potential trajectories of cervical spinous process screws of 100 adults were measured through axial CT in order to establish the general rule for applicability of this technique.

RESULTS: Rigid fixation and solid fusion were achieved in all seven patients included in the study. Biomechanical test results revealed no significant difference between bilateral lateral mass screw fixation and the hybrid lateral mass and spinous process screw fixation constructs. Measurement of the potential trajectory suggested that spinous process screw fixation was a viable technique in the sub-axial cervical spine in the general population.

CONCLUSIONS: The spinous process screw fixation technique in the sub-axial cervical spine is a viable and effective salvage option for patients in whom conventional posterior fixations were not sufficient and salvage, supplementary techniques were required.

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