Stabilization of complex traumatic lesions of the occipitocervical junction with a tapered rod-plate construct

Background/Objective: Occipitocervical fusion is an accepted surgical procedure for the management of atlanto-occipital instability, including traumatic etiologies. Various types of instrumentation have been used to promote fusion. We report experience with the use of a rod-plate construct. Method: 7 patients with traumatic atlanto-occipitial instability underwent occipitocervical fusion. There were 5 men and 2 women (age range, 34-53 years). 4 patients had an atlanto-occipital dislocation, and 3 had complex upper cervical spine fractures. 2 patients with atlanto-occipital dislocation had severe spinal cord injuries as well as a closed head injury. Outcome measures included fusion rates, complications, and functional neurologic status. Results: All patients achieved fusion. No patient experienced neurologic deterioration, and all 5 patients with neurologic injury experienced varying degrees of recovery. 1 patient required re-operation following back-out of his skull screws on one side. Conclusion: In individuals requiring occipitocervical fixation and fusion, an instrumentation system employing a screw-rod construct is a safe, efficacious method for achieving these goals.