Posterior Cervical Stabilization and Fusion: Double-Wire Technique

E. Shannon Stauffer, MD

Material Covered:

There are numerous techniques commonly used to stabilize two or more contiguous vertebral elements in order to prevent motion and provide for fusion. Surgical fusion of the cervical spine is indicated for conditions caused by congenital deformities, trauma including fractures or dislocation, arthritis (both rheumatoid and osteo secondary to degenerative joint disease) and tumors. Any of these conditions which produce instability of the cervical spine may result in pain, limitation of function, progressive deformity, and/or neurologic loss. Immobilization of the responsible segment is therefore mandatory.

Wire techniques for posterior interspinous process-laminar fusion have been found to be the most reliable, least complex method of obtaining satisfactory stability providing for optimal conditions required for fusion. Professor and chairman of the division of orthopedics at SIU School of Medicine, Dr. E. Shannon Stauffer is one of the world's foremost authorities on cervical spine anomalies and their treatment. Dr. Stauffer has developed and subsequently reported numerous wire techniques for specific segmental fusions of the cervical spine. This VJO segment provides an exacting look at one of the common wire techniques for the stabilization and fusion of cervical spine segment C4 and C5.

Patient Information

• 29-year-old male who sustained a traumatic hyperflexion injury in a work-related fall.
• X-rays indicate a subtle step-off between C4 and C5 and a compression fracture of C5; this condition is indicative of a posterior ligamentous rupture.
• Initial conservative treatment involved application of a cervical brace (standing position) for six weeks.
• Six-week extension flexion X-rays show continued subluxation, mild angulation, and separation of C4 and C5. In flexion, obvious subluxation and facet widening are most clearly evident.

Surgical Goal
Realignment of segments C4 and C5, and fusion utilizing double-wire technique with equalization twists and (iliac) bone grafts applied along the lamina and spinous processes between C4 and C5.

References
1. Stauffer ES Management of Spine Fractures C3 to C7 Orthop Clin N Am 17(1):45-53, 1986
2. Stauffer ES Wiring Techniques of the Posterior Cervical Spine for the Treatment of Trauma Orthopedics 11(1):1543-48, 1988

Specifications

• Total Run Time: 15:40 minutes
• Catalog Number: 8007
• VJO Publication Date: December, 1989