CONTOURED ROD COUPLED WITH BONE AND SUBLAMINAER CABLE WIRES IN OCCIPITOCERVICAL JUNCTION FUSION

Objective: Stabilization of the craniocervical junction remains a significant challenge, Different methods of carniocervical fusion have been used, Traditional nonrigid techniques applied in the occiput and cervical spine often fail secondary to postsurgical cranial settling or rotational deformity, rigid fixation of the craniocervicaljunction using Contoured Rod coupled with bone and sublaminaer cable wires should allow correction of deformity in any plane, provide immediate stability without need for external orthosis, and prevent cranial settling. Patients and Methods: A retrospective study on 10 patients with different causes of craniocervical instability who presented to neurosurgical department at Al-Kasr El-Eini Hospital,New Al-Kasr El- Eini Hospital,Cairo University between January 2001 and May 2005 All patients operated upon by using Contoured Rod coupled with bone and sublaminaer cable wires. The mean follow-up period was 17 months (range, 10-24 mos). Complete follow-up including Clinical data and radiographs were obtainedfor all patients immediately postoperatively and every 3 months. The presence of a fusion was determined by clinical and radiographic evaluation. Anteroposterior and lateral radiographs and lateral jlexion-extension radiographs were obtained for all patients. Results: A solid reconstruction was achieved in 8 of 10 cases; there was only one case of pseudoarthrosis required reoperation. One patient (11.11%) experienced a delayed postoperative worsening of myelopathy that resolved without further surgery. 70% of our study improved postoperatively, 20% didn Y and 10 % morality (one case) With 40% had a complication But the stability rate was 100%) and fusion rate was 88.88%. Conclusion: In summary, Contoured Rod in occipitocervical junction coupled with a bone and sublaminaer cable wires fusion, is a safe and effective technique in managing patients with instability at the occipitocervical junction.Thus far, these techniques have resulted in successful bone fusion, and they have eliminated the need for a postoperative halo orthotic device in patients with craniovertebral instability.