Fundamentals in Spinal Surgery for Residents-Fixation of the Cervico-thoracic Junction

Video Transcription

Video Summary

The video features Dr. Frank Lamarck from the University of Michigan discussing fixation techniques of the cervical-thoracic junction. He mentions that despite the importance of these techniques, they are not often talked about due to the off-label use of cervical scolateral mass screws. He emphasizes the need to understand when to consider fixating the cervical-thoracic junction, such as in cases of multi-level degenerative disease, cervical deformities, spinal reconstruction for neoplasms, trauma, and post-infective instability. Dr. Lamarck also discusses the biomechanics of the cervical spine and the importance of understanding how changes in biomechanics can affect patients' daily activities. He highlights the greater load on the posterior elements in the cervical spine compared to the lumbar spine and the better fusion results in the cervical spine according to Wolff's Law. Dr. Lamarck goes on to explain various fixation techniques, including polyaxial screw rod constructs, pedicle screws, and lateral mass screws. He discusses the placement of screws and the importance of avoiding vital structures such as the vertebral artery. He also mentions the use of sublaminar bands and hybrid constructs for added stability. Dr. Lamarck concludes by emphasizing the need for follow-up and considering anterior supplementation if necessary.

Asset Caption

Frank La Marca, MD, FAANS

Keywords

cervical-thoracic junction

fixation techniques

cervical scolateral mass screws

biomechanics

fusion results

screw placement

vertebral artery