Transpedicular osteosynthesis of the subaxial cervical spine: presentation of 4 cases
DOI:
https://doi.org/10.59156/1rhv1970Keywords:
Cervical pedicle screw, Cervical revision surgery, Posterior cervical arthrodesis, Subaxial cervical spineAbstract
Background: cervical pedicle screws (CPS) have demonstrated biomechanical superiority over lateral mass screws, providing more robust fixation in complex cervical spine pathologies. However, their use in the subaxial spine remains limited due to its technical complexity and the potential neurovascular risks.
Objectives: to describe the surgical technique for cervical pedicle screw placement using a fluoroscopy-assisted freehand technique in the subaxial spine (C3-C7), and to assess its safety and efficacy through a case series with complex indications.
Technique description: four clinical cases treated with CPS in the subaxial cervical spine (C3-C7), along with a description of the surgical technique. Indications included basilar invagination with occipitocervical fixation, rigid multisegmental kyphotic deformity, degenerative cervical stenosis, and revision surgery for mechanical failure. In all cases, a fluoroscopy-assisted freehand technique was used, with preoperative planning based on computed tomography.
Conclusion: CPS represents a safe and effective alternative for the treatment of complex subaxial cervical spine pathologies when used with adequate planning and rigorous surgical technique. Their greater biomechanical strength positions them as a particularly useful tool in deformities, revision surgeries, and situations requiring more robust anchorage.
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