Craniocervical Fixation and Fusion

摘要

Surgical stabilization and fusion of the craniocervical junction are indicated for a variety of conditions that cause compression of the spinal cord and medulla through abnormal movements or basilar settling. Historically, decompression and fusion of this region were accompanied by rigid casting or bracing to ensure that bony fusion occurred. However, these bracing methods were uncomfortable and carried their own morbidity in frail and elderly patients. Recently, methods of rigid internal fixation have been developed that often obviate the use of cumbersome external bracing techniques, Two recent innovations that have been used successfully for craniocervical fusion are contoured rod-cable and screw-plate instrumentation systems. The technical aspects of these methods are discussed in detail.