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Asian J Neurosurg. 2019 Jan-Mar;14(1):148-153. doi: 10.4103/ajns.AJNS_305_17.

Modified Inside-outside Occipito-Cervical Plate System: Preliminary Results.

Author information

1
Department of Neurosurgery, Ankara University, School of Medicine, Ankara, Turkey.
2
Department of Neurosurgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Neurosurgery Clinic, Ankara, Turkey.
3
Department of Neurosurgery, Ministry of Health, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Neurosurgery Clinic, Istanbul, Turkey.
4
Department of Neurosurgery, Cumhuriyet University, School of Medicine, Sivas, Turkey.
5
Department of Neurological Surgery, UPMC Hamot, Erie, PA, USA.

Abstract

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.

KEYWORDS:

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

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