Contoured Loop and Modifi ed Wiring Technique for occipitocervical Fixation - A Safe and Effi cacious Option
Journal Title: Nepal Journal of Neuroscience - Year 2018, Vol 15, Issue 2
Abstract
To study the safety and effi cacy of contoured loop and modifi ed wiring techniques for occipitocervical fi xation. Retrospective study among 15 patients who underwent occipitocervical fi xation from Jan 2011-16 were reviewed. Contoured loop was wired at 2 points in occiput and 4 different points, 2 on either side to percutaneously passed K wire through the spino laminar junctions of C2 and C3. Additional fusion with onlay autologous graft from either iliac crest or ribs was done. Various parameters studied were patient’s demography, causes of instability, change in neurological function, complications and radiographic outcome.Six had basilar invagination, 4 had traumatic atlantoaxial subluxation, 4 had osodontoidium and 1 had Rheumatoid arthropathy. There was improvement in Frankel grade from C to D in 6 and from D to E in 5 patients. Radiological union at 6 months was observed in all 15 cases. Two patients had surgical site infection. Dislodgement of K wire was found in 4 cases (26.66%) by which time radiological union had already taken place. The approximate cost of instrumentation was 100 dollars for each patient. Conclusions. Contoured rod and modifi ed wiring occipitocervical fi xation technique are relatively a safe, cheap and technically easy alternative for the management of occipitocervical instability.
Authors and Affiliations
Shikher Shrestha, FCPS
Keywords
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