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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(01): 148-153
DOI: 10.4103/ajns.AJNS_305_17
Original Article

Modified inside-outside occipito-cervical plate system: Preliminary results

Sukru Caglar
Department of Neurosurgery, Ankara University, School of Medicine, Ankara
,
Erhan Turkoglu
1   Department of Neurosurgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Neurosurgery Clinic, Ankara
,
Hayri Kertmen
1   Department of Neurosurgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Neurosurgery Clinic, Ankara
,
Bora Gurer
2   Department of Neurosurgery, Ministry of Health, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Neurosurgery Clinic, Istanbul
,
Huseyin Bozkurt
3   Department of Neurosurgery, Cumhuriyet University, School of Medicine, Sivas
,
Rafet Ozay
1   Department of Neurosurgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Neurosurgery Clinic, Ankara
,
Sahin Hanalioglu
1   Department of Neurosurgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Neurosurgery Clinic, Ankara
,
Efkan Colpan
4   Department of Neurological Surgery, UPMC Hamot, Erie, PA
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Context: Internal rigid fixation provides immediate stability of the occipito-cervical (OC) junction for treatment of instability; however, in current practice, the optimal OC junction stabilization method is debatable. Aims: The aim of this study to test the safety and efficacy of a newly designed modified inside-outside occipito-cervical (MIOOC) plate system for the treatment of instability. Settings and Design: This was a feasibility study of MIOCC plate system. Subjects and Methods: Five male and four female patients with OC instability were treated using MIOOC plate system. Stabilization rate, safety, and efficacy were evaluated radiologically and clinically. Results: Mean age of the patients was 35 ± 11 (range: 22–58) years. Etiology of OC instability included trauma, neoplasm, congenital abnormalities, and iatrogenic. The fusion levels ranged from occiput-C3 to occiput-C6. Mean follow-up duration was 22 ± 10 (range: 6–46) months. There were neither complication nor was there any need for plate revision or screw pullout. Mortality occurred in one patient due to primary malignancy at 6 months; otherwise, no morbidity was observed. During the follow-up, no recurrent subluxation or newly developed instability at adjacent levels occurred. All patients showed a satisfactory union at the most recent follow-up examination. Conclusions: These preliminary results suggest that the MIOCC plate system is a useful and safe method for providing immediate internal stability of the OC junction. Using a multi-piece plate design in this plate system provided easy implantation and a better interface between plate and OC bones. Further, clinical studies and long-term results are needed to determine the reliability of the MIOOC plate system.

Key-words:

Biomechanical system - C1–C2 fixation - craniovertebral junction - inside-outside - multi-piece plate - occipito-cervical

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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