Inside-outside technique for posterior occipitocervical spine instrumentation and stabilization: Preliminary results

T. Glenn Pait, Ossama Al-Mefty, Frederick Boop, Kenan I. Arnautovic, Salim Rahman, Wade Ceola

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Object. The authors present a series of 16 patients who underwent inside-outside occipital and posterior cervical spine stabilization. Methods. In this technique, the screw was placed from the inside of the occiput to the outside. An articular (lateral) mass plate was contoured to the shape of the occipital bone and the cervical spine and affixed to the occiput with a flat- headed screw or stud placed through a burr hole in the calvaria with the fiat head of the screw in the epidural space and the threads facing outward. The bone plate was then secured with a nut to the occipital screw and the cervical plate was attached to the spine with a bone screw that coursed through the plate and into the articular pillar. Our series included six children and 10 adults. In five patients, previous fusion had failed; in two patients spinal instability was secondary to Down's syndrome; two patients' instability was related to developmental anomalies; and in five patients spinal instability was due to the presence of tumor. One patient with rheumatoid arthritis had undergone a transoral procedure. Two patients had suffered traumatic fracture. Three patients died of causes unrelated to the procedure, one patient died of metastatic cancer, and one patient died in a long term care facility of cardiopulmonary complications. One patient with renal failure suffered a hemorrhage from an arteriovenous fistula after being treated with dialysis. In one child, a nut backed off after 3 months. The nut was reseated, and a maturing arthrodesis was present. Conclusions. The authors conclude that the inside-outside occipitocervical fixation is an effective technique for stabilizing the cervical spine.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Neurosurgery
Volume90
Issue number1 SUPPL.
StatePublished - Jan 1 1999
Externally publishedYes

Fingerprint

Spine
Nuts
Joints
Occipital Bone
Bone Screws
Bone Plates
Epidural Space
Arthrodesis
Arteriovenous Fistula
Long-Term Care
Down Syndrome
Skull
Renal Insufficiency
Dialysis
Rheumatoid Arthritis
Neoplasms
Head
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Pait, T. G., Al-Mefty, O., Boop, F., Arnautovic, K. I., Rahman, S., & Ceola, W. (1999). Inside-outside technique for posterior occipitocervical spine instrumentation and stabilization: Preliminary results. Journal of Neurosurgery, 90(1 SUPPL.), 1-7.

Inside-outside technique for posterior occipitocervical spine instrumentation and stabilization : Preliminary results. / Pait, T. Glenn; Al-Mefty, Ossama; Boop, Frederick; Arnautovic, Kenan I.; Rahman, Salim; Ceola, Wade.

In: Journal of Neurosurgery, Vol. 90, No. 1 SUPPL., 01.01.1999, p. 1-7.

Research output: Contribution to journalArticle

Pait, TG, Al-Mefty, O, Boop, F, Arnautovic, KI, Rahman, S & Ceola, W 1999, 'Inside-outside technique for posterior occipitocervical spine instrumentation and stabilization: Preliminary results', Journal of Neurosurgery, vol. 90, no. 1 SUPPL., pp. 1-7.
Pait, T. Glenn ; Al-Mefty, Ossama ; Boop, Frederick ; Arnautovic, Kenan I. ; Rahman, Salim ; Ceola, Wade. / Inside-outside technique for posterior occipitocervical spine instrumentation and stabilization : Preliminary results. In: Journal of Neurosurgery. 1999 ; Vol. 90, No. 1 SUPPL. pp. 1-7.
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