[Dorsal occipitocervical fusion--indications and results]

Z Orthop Ihre Grenzgeb. 1998 Jul-Aug;136(4):364-74. doi: 10.1055/s-2008-1053751.
[Article in German]


Study design: This report will relate to our experience with the occipitocervical fusion with the y-plate, which we used in the treatment of 53 patients.

Methods: 39 of the patients had rheumatoid arthritis. Other indications demanding surgery were posttraumatic conditions, degenerative and congenital lesions, osteomyelitis, tumor and psoriasis arthritis. Before surgery, all patients suffered from pain in the neck and/or in the back of the head. On a linear scale from 0 to 10, the pain was rated as 8.0 in average (range 4 to 10). 33 patients had an instability of the atlantoaxial region and 26 patients a basilar invagination of the odontoid. A cervical myelopathy was found in 23 cases. One surgeon fused the occiput to C2 in 30 cases, to C3-C5 in 14 cases and to C7-T2 in 9 cases. In 17 patients a resection of the odontoid had to be performed before fusion to adequately decompress the spinal cord.

Results: 31 of the patients could be controlled with a follow-up of at average 45.9 months. 16 patients had died. At the time of follow-up, the pain was rated as 2.1 in average (range 0 to 8). The myelopathy cleared up in all cases but 3.9 patients required further operations on the cervical spine. 5 patients developed an instability at the level(s) below the fusion and an enlargement of the fusion to these levels had been performed. The fusion rate was 98.1%. The results were satisfying in 25 (80.6%) and not satisfying in 5 patients (19.4%).

Conclusions: These results show the effectiveness of the occipitocervical fusion with the y-plate in a wide range of applications. It offers advantages above other techniques.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Plates*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Occipital Bone / diagnostic imaging
  • Occipital Bone / surgery*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Radiography
  • Reoperation
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / surgery
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / etiology
  • Spinal Diseases / surgery*
  • Spinal Fusion / instrumentation*
  • Spinal Injuries / diagnostic imaging
  • Spinal Injuries / etiology
  • Spinal Injuries / surgery*
  • Treatment Outcome