Clinical and radiographic outcomes of posterior cervical arthrodesis and stabilization via lateral mass screwing and rod fixation: a retrospective study at a tertiary hospital in Addis Ababa, Ethiopia

后路颈椎融合及侧块螺钉和棒固定术的临床和影像学结果:埃塞俄比亚亚的斯亚贝巴一家三级医院的回顾性研究

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Abstract

BACKGROUND: Lateral mass screw and rod fixation is widely used for posterior cervical arthrodesis and stabilization in cases of cervical instability, trauma, neoplasm, decompression, and deformity correction. However, clinical and radiological data on its outcomes, especially in our setting, remain limited. OBJECTIVE: Clinical and radiographic evaluation of posterior cervical arthrodesis and stabilization using lateral mass screws and rod fixation. METHODS: A retrospective cross-sectional study of lateral mass screw and rod fixation from September 2019 to September 2024 was performed, and the clinical and radiographic parameters were evaluated. Sixty-six patients were assessed via a structured questionnaire. Clinical parameters were assessed by the ASIA score, functional assessment in degenerative conditions (mJOA), and radiographic evaluation (computed tomography and dynamic X-ray) of 325 lateral mass screws inserted into the evaluated patients. Complications were assessed from a patient chart and radiology archive. RESULTS: Patients ranged from 16 to 75 years in age (40.1), and 84.9% of the patients were between the ages of 20 and 60. Trauma accounted for 92.4% of the indications, with fracture dislocations being C4/C5 (28.8%), C5/C6 (25.8%), C6/C7 (16%), and C4/5 (10.8%)-unilateral locked facets in 4.5% and floating lateral masses in 6% of patients. A total of 325 screws were placed, with C5 being the most common (110 screws). There was no postoperative change in the ASIA score. The complications included dural tear (3%), joint violation (1.9%), hardware failure (1 patient), and postoperative surgical site infection (6%). The postoperative follow-up ASIA score was significantly associated with the preoperative score, with a likelihood ratio and Fisher's exact test P value < 0.001. The mean postoperative follow-up mJOA score was 13.3 ± 0.58, which was greater than the preoperative mean mJOA score, which was 8.67 ± 1.16. CONCLUSION: Lateral mass screw and rod fixation is an effective method of cervical stabilization in our setting. CLINICAL TRIAL NUMBER: Not applicable.

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