Novel High-Precision Technique for Subaxial Cervical Fixation Shows Promise, finds research

A new study published in the Journal of Surgery showed that a novel technique using lateral mass screws provides a precise, safe, and low-complication method for subaxial cervical fixation, especially in cases needing posterior stabilization. However further research with larger patient groups and long-term follow-up is suggested to confirm its effectiveness.

Trauma, degenerative diseases, and tumors are among the frequent causes of pathology in the subaxial cervical spine. A biomechanically sound method of attaining stability is posterior cervical fixation using lateral mass screws (LMS). The main differences between established methods, such as those outlined by Anderson, An, Roy-Camille, and Magerl, are in angulation, trajectory, and entrance point. These methods do, however, have the potential to cause neurovascular harm, like damage to the vertebral arteries and spinal roots. Because of the lateral masses' intricate anatomy and close proximity to vital organs, including the nerve roots and spinal arteries, careful screw placement is required.

Complications include lateral mass fractures, screw malposition, and neurovascular injuries, which are still a problem even with improvements in surgical methods. Thus, this study was to present a new method of subaxial cervical fixation using lateral mass screws, with a focus on clinical results, safety, and anatomical accuracy.

30 patients receiving cervical spine surgery using the suggested approach were retrospectively analyzed. A consistent categorization system was used to assess the precision of screw insertion (G0-G4). Facet fractures and lateral migration were among the complications noted. When appropriate, comparative evaluations and descriptive statistics were incorporated into the statistical analysis.

Of the 204 screws examined, 32.35% had little cortical perforation (G1) and 59.31% had no deviation (G0). Facet fractures (1.96%) and lateral migration (3.43%) were among the complications. 91.66% was the total accuracy rate (G0 + G1). The suggested strategy showed a good safety profile and similar attachment strength to conventional methods.

Overall, a precise and secure alternative for subaxial cervical fixation is provided by the innovative LMS method. It is a prospective substitute for well-established techniques due to its high accuracy rate and low complication rate. In our first series, the precision and tolerable complication rates (5.39%) of our modified lateral mass screw approach demonstrated that it provides a dependable, navigation-independent alternative for subaxial cervical fixation.

Reference:

Subaxial cervical fixation with lateral mass screws: A technique variant. (2025). Journal of Surgery (Lisle, IL), 10(4). https://doi.org/10.29011/2575-9760.011287