A systematic review of occipital cervical fusion: techniques and outcomes.

摘要: OBJECT Numerous techniques have been historically used for occipitocervical fusion with varied results. The purpose of this study was to examine outcomes various surgical in patients disease states elucidate the most efficacious method stabilization junction. METHODS A literature search peer-reviewed articles performed using PubMed and CINAHL/Ovid. key words "occipitocervical fusion," fixation," "cervical instrumentation," instrumentation" were relevant articles. Thirty-four studies identified that met criteria. Within these studies, 799 adult who underwent posterior analyzed radiographic clinical including rate, time fusion, neurological outcomes, rate adverse events. RESULTS No stronger than Class IV literature. Among within cited articles, use screw/rod instrumentation constructs associated a lower postoperative events (33.33%) (p < 0.0001), rates failure (7.89%) improved (81.58%) 0.0001) when compared wiring/rod, screw/plate, onlay situ bone grafting techniques. technique highest wiring rods (95.9%) = 0.0484), which also demonstrated shortest 0.0064). Screw/rod had high fusing 93.02% cases. When comparing depending on status, inflammatory diseases lowest (0%) improvement (90.91%) following Occipitocervical treatment tumors by (57.14%) 0.0089). Traumatic causes instability percentage pain screw/plates (100% improvement) 0.0001). CONCLUSIONS Based existing literature, are very favorable all categories assessed processes. For requiring arthrodesis diseases, while is least outcomes. diagnosis tumor successful techniques, arthrodesis. nonspecified group improvement.