Cervical decompressive laminectomy and lateral mass screw-rod arthrodesis: surgical experience and analytical review of 4120 consecutive screws

Background: Cervical decompressive laminectomy with lateral mass arthrodesis is a common neurosurgical procedure used to address a variety of cervical spine pathologies. Purpose: This study aimed to determine the safety and efficacy of this neurosurgical procedure using the Anderson–Sekhon technique for screw trajectory. Methods: The study retrospectively reviewed all clinical and radiological indicators for patients who underwent lateral mass arthrodesis between December 2005 and December 2017. All patients underwent polyaxial screw-rod implants using the Anderson–Sekhon technique for screw trajectory. It additionally reported all intra- and post-operative complications, along with short- and long-term outcomes for these patients. The follow-up period ranged from 2 months to 10 years. Results: The study evaluated 695 patients who received a total of 4120 lateral mass screws. This is considered the largest reported case series up to date. No patients had neuro-vascular injuries. The main complications included 51 (7.3%) cases of screw malposition, as when the screw had breached either of foramen transversarium, neural foramen, or the facet joint; 39 (5.6%) cases of lateral mass breakdown; 29 (4.2%) cases of C5 root pain which has subsided overtime; 22 (3.2%) of incidental durotomy; and 18 (2.6%) cases of postoperative wound infection. There were only 3 cases of screw pullout leading to a stability rate of 99.5%. Most cases demonstrated very good to excellent outcomes on both short- and long-term follow-up. Conclusions: Cervical decompressive laminectomy with lateral mass arthrodesis is a safe and effective technique for the management of different cervical spine pathologies, which results in favourable short- and long-term outcomes.