Posterior stabilization of C3/C4 vertebrae: A technical case report

Abstract

While there are several approaches to cervical screw fixation surgery, the two most common modes of placement are pedicle and lateral mass screws. Both techniques have their respective complications such as neurological deficits, vascular injury, compromise to bone quality, or chronic postoperative pain. This report suggests a novel technique that utilizes the surgical plan of lateral mass screw insertion with modifications to control for the commonly reported complications associated with it. The procedure illustrated in this report was performed on a patient with a history of spine surgery and persistent neurological deficits. When approaching such patients, it is vital to adjust the screw angulation based on the individual’s anatomy. The modified Roy-Camille technique proposed in this report can be applied to other patients undergoing cervical spine surgery and may yield favorable outcomes with respect to minimizing neurovascular injury and maximizing postoperative recovery. This can be accomplished based on each patient’s unique presentation, individual anatomy, symptomatology, and surgical history.