ORIGINAL ARTICLE   

Journal of Neurosurgical Sciences 2024 Nov 19

DOI: 10.23736/S0390-5616.24.06255-6

Copyright © 2024 EDIZIONI MINERVA MEDICA

language: English

Comparison of intra-operative skull fixation techniques on cervical sagittal parameters

Connor C. JACOB ✉, Ryan G. EATON, Andrew J. GROSSBACH, Asad AKHTER, Nathaniel TOOP, Joshua WANG, Joravar DHALIWAL, Stephanus V. VILJOEN

Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, OH, USA

BACKGROUND: There is limited literature concerning the use of bi-vector traction to a Mayfield following posterior cervical fusion with respect to cervical alignment parameters. The objective of this study was to determine how variability of intra-operative fixation methods for posterior cervical fusion affects post-operative cervical sagittal alignment parameters.
METHODS: After institutional review board (IRB) approval, retrospective chart review of a total of 54 patients who underwent posterior cervical fusion from July 2017 to December 2019 was conducted. The patients were divided into two cohorts based on their intra-operative positioning, those who were affixed to a three-point fixation system, and those who were placed in bi-vector traction. Pre- and post-operative cervical alignment parameters were measured.
RESULTS: There was no difference in post-operative sagittal parameters between the two groups. Each group showed a statistically significant difference in T1-slope when comparing pre- and post-operative measurements.
CONCLUSIONS: In our study we did not find that any of our techniques including bi-vector traction, static Mayfield positioning, or dynamic Mayfield positioning were very effective in adding lordosis during posterior cervical fusion surgeries. Interestingly, we also found a statistically significant increase in T1 slope and resulting trend towards increased cervical SVA.

KEY WORDS: Skull; Traction; Fixation techniques