Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography Suite

Background: Posterior cervical fusion (PCF) is widely used for cervical spinal cord decompression with/without fusion. In our hybrid operating room, intraoperative computed tomography (iCT) is routinely used to verify screw placement. This study analyzed clinical and radiological outcomes after PCF...

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Main Authors: Armando Dolp, Abdussalam Khamis, Javier Fandino, Jenny C. Kienzler
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/2/160
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author Armando Dolp
Abdussalam Khamis
Javier Fandino
Jenny C. Kienzler
author_facet Armando Dolp
Abdussalam Khamis
Javier Fandino
Jenny C. Kienzler
author_sort Armando Dolp
collection DOAJ
description Background: Posterior cervical fusion (PCF) is widely used for cervical spinal cord decompression with/without fusion. In our hybrid operating room, intraoperative computed tomography (iCT) is routinely used to verify screw placement. This study analyzed clinical and radiological outcomes after PCF and evaluated iCT benefits for detecting screw misplacement. Methods: Nineteen patients underwent PCF between March 2012 and April 2016 for degenerative (n = 6), neoplastic (n = 7), and traumatic (n = 6) conditions. Seven patients had primary PCF, while twelve underwent PCF following anterior fusion due to segmental instability with cervical malalignment (n = 11) or tumor progression (n = 1). Results: The mean patient age was 59 ± 11 years, with 63% male patients. The median follow-up was 21 months. PCF averaged 4.74 segments (range: 1–9). At follow-up, 79% reported pain improvement and normal sensorimotor function. Of six patients with preoperative paresis, five showed improved muscle strength. No persistent gait disturbances occurred. Complications requiring revision occurred in four patients (21%): three surgical site infections and one cerebrospinal fluid leak. One perioperative death occurred (5%). iCT detected incorrect screw placement in seven patients (36%), allowing the immediate repositioning of eight screws, preventing later revision surgeries. The overall fusion rate was 92%. Conclusions: PCF with iCT is safe and effective for various cervical spine pathologies, yielding good long-term clinical outcomes. iCT effectively detects and enables immediate correction of screw malposition, reducing revision surgery needs. This imaging modality demonstrates high sensitivity and specificity for identifying clinically relevant screw malpositions.
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spelling doaj-art-359aa8e510b341b5b7a9acdd150b6c1c2025-08-20T03:12:16ZengMDPI AGBrain Sciences2076-34252025-02-0115216010.3390/brainsci15020160Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography SuiteArmando Dolp0Abdussalam Khamis1Javier Fandino2Jenny C. Kienzler3Department of Neurosurgery, Cantonal Hospital Aarau, 5001 Aarau, SwitzerlandDepartment of Spine Surgery, Hospital Center Biel, 2501 Biel, SwitzerlandDepartment of Neurosurgery, Hirslanden Medical Center, 5001 Aarau, SwitzerlandDepartment of Neurosurgery, Cantonal Hospital Aarau, 5001 Aarau, SwitzerlandBackground: Posterior cervical fusion (PCF) is widely used for cervical spinal cord decompression with/without fusion. In our hybrid operating room, intraoperative computed tomography (iCT) is routinely used to verify screw placement. This study analyzed clinical and radiological outcomes after PCF and evaluated iCT benefits for detecting screw misplacement. Methods: Nineteen patients underwent PCF between March 2012 and April 2016 for degenerative (n = 6), neoplastic (n = 7), and traumatic (n = 6) conditions. Seven patients had primary PCF, while twelve underwent PCF following anterior fusion due to segmental instability with cervical malalignment (n = 11) or tumor progression (n = 1). Results: The mean patient age was 59 ± 11 years, with 63% male patients. The median follow-up was 21 months. PCF averaged 4.74 segments (range: 1–9). At follow-up, 79% reported pain improvement and normal sensorimotor function. Of six patients with preoperative paresis, five showed improved muscle strength. No persistent gait disturbances occurred. Complications requiring revision occurred in four patients (21%): three surgical site infections and one cerebrospinal fluid leak. One perioperative death occurred (5%). iCT detected incorrect screw placement in seven patients (36%), allowing the immediate repositioning of eight screws, preventing later revision surgeries. The overall fusion rate was 92%. Conclusions: PCF with iCT is safe and effective for various cervical spine pathologies, yielding good long-term clinical outcomes. iCT effectively detects and enables immediate correction of screw malposition, reducing revision surgery needs. This imaging modality demonstrates high sensitivity and specificity for identifying clinically relevant screw malpositions.https://www.mdpi.com/2076-3425/15/2/160cervical spinefusionposteriorsurgical techniqueoutcomehybrid OR
spellingShingle Armando Dolp
Abdussalam Khamis
Javier Fandino
Jenny C. Kienzler
Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography Suite
Brain Sciences
cervical spine
fusion
posterior
surgical technique
outcome
hybrid OR
title Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography Suite
title_full Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography Suite
title_fullStr Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography Suite
title_full_unstemmed Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography Suite
title_short Clinical and Radiological Outcome of Posterior Cervical Fusion Using Philips AlluraXper FD20 Angiography Suite
title_sort clinical and radiological outcome of posterior cervical fusion using philips alluraxper fd20 angiography suite
topic cervical spine
fusion
posterior
surgical technique
outcome
hybrid OR
url https://www.mdpi.com/2076-3425/15/2/160
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