Abstract
Study design: Original article.
Objective: The authors present seven cases who underwent one-stage suboccipital, C1 and/or C2 posterior decompression and fusion by Luque rod, wiring and autogenic bone graft for occipito-cervical instability and neural compression.
Setting: Chang Gung University and Medical Center at Kaohsiung, Taiwan.
Method: Since January 1996, 20 cases of craniovertebral and upper cervical spinal instability were encountered. Seven of these cases had no neurological improvment under Cone-Barton Skeletal traction. Imaging studies revealed poor reduction with persistent neural compression. One patient underwent unsuccessful anterior trans-oral vertebrectomy for decompression. All patients underwent posterior suboccipital craniectomy, C1 and/or C2 laminectomy for decompression. Contoured Luque rod with wiring and autogeneic bone graft was used for craniocervical fusion. After surgical treatment, halo-vest or sterno-occipito-mandibular immobilizer (SOMI) was used for 3–6 months
Results: Suboccipital craniectomy and C1 laminectomy could afford a 30–50% increment of anteroposterior diameter in the neural canal and effective decompression of the low medulla and cord. All patients made neurological improvement. The ASIA-MIS scores improved from pre-operative 49 (mean) to 78. Four patients can walk without any support. There were no major complications except for one case requiring readjustment of the halo-vest brace.
Conclusion: The authors recommend this procedure as one choice for relieving craniocervical instability with neurological compromise. A programmed rehabilitation will afford better neurological improvement.
Spinal Cord (2001) 39, 101–108.
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Chen, HJ., Cheng, MH. & Lau, YC. One-stage posterior decompression and fusion using a Luque rod for occipito-cervical instability and neural compression. Spinal Cord 39, 101–108 (2001). https://doi.org/10.1038/sj.sc.3101110
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DOI: https://doi.org/10.1038/sj.sc.3101110