Complications of posterior articular mass plate fixation of the subaxial cervical spine in 43 consecutive patients

Study Design. A retrospective study evaluating the complications in 43 consecutive patients treated with posterior lateral mass plate fixation of the subaxial cervical spine. Objectives. To determine the surgical complications of applying posterior lateral mass plates, to correlate complication rate with surgical technique, and to determine fusion rate. Summary of Background Data. Posterior cervical plate stabilization is a viable alternative to more traditional wiring techniques. Advantages include superior internal stability and no requirement for intact posterior spinal elements. Methods. Records of 43 consecutive patients who underwent posterior articular mass plate fixation were independently reviewed to identify associated complications. The average follow-up was 25 months (range, 1 to 63 months). The most common indications for surgery were posttraumatic instability (n = 22) and instability after multilevel laminectomy (n = 14). Four patients had difficult spinal disorders requiring a combined anterior and posterior approach. Results. Two hundred eighty-one screws were inserted in the cervical spine (average, 7 screws per patient). There were no complications associated with placement of the screws (i.e., root injury or vertebral artery injury). Complications included two cases in which patients had superficial wound infections and one in which the patient had a spinal epidural hematoma requiring evacuation, In one patient, hardware failure required an anterior approach to correct a progressive angulation. Conclusions. With the authors' surgical technique, lateral mass plate fixation is safe and effective. There were no nerve root or vertebral artery injuries.