Posterior cervical decompressive laminectomy and lateral mass screw fixation.

OBJECTIVE To review the results and complications of cervical decompressive laminectomy and lateral mass screw fixation. METHODS This retrospective study was carried out between October 2006 and January 2010 at King Abdullah University Hospital, Irbid, Jordan. Over 40 months, 405 lateral mass screws were placed in 50 patients aged 22-65 years (17 females, and 33 males) for variable cervical pathologies including degenerative disease, trauma, and neoplasm. All cases were performed with a polyaxial screw/rod construct. Most patients had 14 mm length and 3.5 mm diameter screws placed. The screw location was evaluated by postoperative plain x-ray and CT. The facet joint, foraminal and foramen transversarium violation were also assessed. RESULTS All screws were placed using the Anderson or Sekhon methods. No patients experienced neural or vascular injury as a result of screw position. One patient needed screw repositioning. Three patients experienced superficial wound infection. Five patients experienced pain around the shoulder of C5 distribution that subsided over time. No patients had screw pullouts or symptomatic adjacent segment disease. Postoperative CT scanning showed no compromise of the foramen transversarium or neural foramen in the vast majority of the patients. CONCLUSION Lateral mass screw stabilization is a safe and effective surgical technique. This study exhibits the safety and effectiveness of lateral mass fixation for a variety of subaxial cervical spine disease.