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Spinal cord compression by multistrand cables after solid posterior atlantoaxial fusion. Report of three cases.

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Title: Spinal cord compression by multistrand cables after solid posterior atlantoaxial fusion. Report of three cases.
Authors: Sudo, Hideki Browse this author
Abumi, K. Browse this author
Ito, M. Browse this author
Kotani, Y. Browse this author →KAKEN DB
Keywords: multistrand cable
spinal cord compression
atlantoaxial fusion
Issue Date: Oct-2002
Publisher: American Association of Neurological Surgeons
Journal Title: Journal Of Neurosurgery
Volume: 97
Issue: 3 Suppl
Start Page: 359
End Page: 361
PMID: 12408393
Abstract: The sublaminar wiring procedure has been commonly used for stabilizing the atlantoaxial complex. Multistrand braided cables were introduced in the early 1990s. In previous biomechanical studies these cables were demonstrated to be superior to monofilament wires in terms of their flexibility, mechanical strength, and fatigue-related characteristics. To the authors' knowledge, they are the first to describe clinically the occurrence of delayed spinal cord compression resulting from multistrand cables after the completion of rigid spinal arthrodesis in the upper cervical spine. Three patients underwent posterior atlantoaxial fusion in which two sublaminar multistrand cables were placed. Between 15 and 48 months postoperatively, they suffered from upper- and lower-extremity numbness as well as gait disturbance. Plain radiography and computerized tomography myelography revealed spinal cord compression caused by the sublaminar cables, although fusion was complete and physiological alignment was maintained at the fused segment. The radiographs obtained immediately after surgery demonstrated that the initial cable placement had been properly performed. The shape of the cable at the initial surgery was oval and then gradually became circular. The anterior arc of the circular shape of the cable in fact led to the spinal cord compression. Considering the mechanism of this late complication, a cable tends to spring open because of its high flexibility and becomes circular shaped even after the complete arthrodesis. When applying multistrand cables for intersegmental fixation at the atlantoaxial complex, delayed complications related to bowing of the cables is possible.
Rights: The final version of the paper was published in Journal Of Neurosurgery, vol. 97-3. For reuse of any of the materials, including editorial copy, figures, or tables please contact the Journal of Neurosurgery at
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 須藤 英毅

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