Use of Bivector Traction for Stabilization of the Head and Maintenance of Optimal Cervical Alignment in Posterior Cervical Fusions. (May 2017)

• Record Type: Journal Article
• Authors: Karikari, Isaac O.; Bumpass, David B.; Gum, Jeffrey; Sugrue, Patrick; Chapman, Todd M.; Elsamadicy, Aladine A.; Riew, K. Daniel
• Is Part Of: Global spine journal. Volume 7:Number 3(2017)
• Page Start: 227
• Page End: 229
• Publication Date: 2017-05
• Subjects: cervical fusions -- posterior -- Mayfield headholder -- cranium -- Gardner-Wells tongs -- traction -- bivector -- cervical alignment; Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1177/2192568217694146
• Languages: English
• ISSNs: 2192-5682

Abstract

Study Design: Retrospective analysis of consecutive case series. Objective: To introduce a novel method of stabilizing the cranium using bivector traction in posterior cervical fusions. Methods: A retrospective review of 50 consecutive patients undergoing instrumented posterior cervical arthrodesis was performed. All patients had at least 3 levels of subaxial fusion using the bivector traction apparatus. Patients' demographic data was recorded for the following: pre- and postoperative cervical lordosis, pre- and postoperative cervical sagittal vertical alignment (cSVA), and intraoperative complications from pin placements. Results: A total of 50 patients were studied. There were 31 females and 19 males. The mean age at the time of surgery was 49 years (range 35-79). A mean 5.8 levels were fused. The most common levels fused were C2-T3 in 14 patients followed by C2-T2 in 7 patients. In no case did the surgeon or assistant have to scrub out to adjust the alignment. The mean pre- and postoperative cervical lordosis was −6.0° and −10°, respectively ( P = .04). The mean pre-and postoperative cSVA was 30.5 mm and 32 mm, respectively ( P = .6). There were no complications related to placement of the Gardner-Well tongs. Conclusion: The bivector traction is an easy, safe, and effective method of stabilizing the head and obtaining adequate cervical sagittal alignment.