Occipitocervical fusion for XXXX using the inside-outside stabilization technique.

@entity1 @entity51 @entity4048 @entity158 @entity3473 @entity309
STUDY DESIGN: A retrospective study investigating the clinical outcome of the inside-outside cranial bolt technique for occipitocervical stabilization used to manage @entity309 was conducted. OBJECTIVE: To evaluate the safety and efficacy of the inside-outside technique for occipitocervical stabilization used to manage @entity309 @entity1 . SUMMARY OF BACKGROUND DATA: Achieving occipital cervical fusion for @entity1 with @entity309 is a complex and challenging problem. Complications related to placement of occipital screws have been reported. METHODS: Occipitocervical stabilization was used for @entity3473 in 21 @entity1 with @entity309 . The @entity1 were assessed for pre- and postoperative neurologic status (Ranawat classification), @entity4048 , fusion and alignment, hardware complications, and continued posterior cranial settling. All the @entity1 underwent stabilization using inside-outside occipital screws. The technique involves bilateral fixation of cervical plates to the occiput using inside-outside screws, and to the cervical spine using pars screws at C2 or lateral mass screws at subaxial levels. Bone grafting was accomplished with autologous rib or iliac crest graft. RESULTS: During the study, 14 @entity1 and 7 @entity1 with @entity309 underwent occipitocervical stabilization and fusion. The average age of the @entity1 was 65 years, and the mean follow-up period was 25.5 months. There were no surgical complications. Neck @entity158 was reduced from an average Ranawat @entity158 score of 2.40 to 0.4 (P < 0.0001). The Ranawat neurologic grade improved in 62% of the @entity1 with preoperative @entity51 . Further cranial settling was not observed in any @entity1 . There were no complications from implants and no incidence of instrumentation failure. CONCLUSIONS: The "inside-outside" technique is safe and effective for stabilizing the occipitocervical junction in @entity309 @entity1 . It is associated with significant @entity4048 , improved neurologic status, and maintenance of alignment and stability.
