Head of Neurosurgery Devadoss Hospital, Madurai, India Madurai, Tamil Nadu, India
Introduction: To report our experience with transarticular facet screw fixation (TAFS) of the subaxial cervical spine (SCS) and discuss the advantages and limitations of this technique.
Methods: From 2010 to 2019, 26 patients underwent TAFS. Inclusion criteria were :1. Multilevel (3 or more levels) degenerative cervical myelopathy (DCM), 2. preserved cervical lordosis or dynamic radiographs showing that lordosis can be restored by extension, 3. multilevel DCM with associated instability on dynamic radiographs , 4. As a part of a 360* fusion. Preoperatively, all patients were assessed by Nurick’s grading, dynamic radiographs, MRI and CT cervical spine. Post-operatively, all patients underwent plain radiographs, CT cervical spine and 20 patients underwent MRI. The median follow up was 18 months. Takayasu’s and DalCanto’s tehniques were used initially and later our technique was used for TAFS. Complications were recorded. Axial neck pain was assessed by Visual Analog Scale(VAS).
Results: From 2010 to 2019, 26 patients underwent TAFS. Inclusion criteria were :1. Multilevel (3 or more levels) degenerative cervical myelopathy (DCM), 2. preserved cervical lordosis or dynamic radiographs showing that lordosis can be restored by extension, 3. multilevel DCM with associated instability on dynamic radiographs , 4. As a part of a 360* fusion. Preoperatively, all patients were assessed by Nurick’s grading, dynamic radiographs, MRI and CT cervical spine. Post-operatively, all patients underwent plain radiographs, CT cervical spine and 20 patients underwent MRI. The median follow up was 18 months. Takayasu’s and DalCanto’s tehniques were used initially and later our technique was used for TAFS. Complications were recorded. Axial neck pain was assessed by Visual Analog Scale(VAS)..
Conclusion : TAFS is a simple, safe, biomechanically superior and cost-efffective technique of posterior instrumented fusion of SCS. The low implant profile makes it ideal for combining it with laminoplasty.
How to Improve Patient Care: This simple technique of posterior instrumented fusion of the subaxial cervical spine will provide greater biomechanical strength to the construct while simultaneously reducing the cost of instrumentation.
