Outcome of Lateral Mass Screw Fixation in Traumatic Cervical Spine Injury at the National Orthopaedic Hospital, Dala, Kano, Nigeria
TL;DR
The continued use of this technique in Nigerian tertiary centres for managing unstable subaxial cervical trauma demonstrates favourable neurological recovery, high fusion rates and acceptable complication rates, comparable to international series.
Abstract
Background: Traumatic cervical spine injuries are associated with significant morbidity and mortality, often requiring surgical stabilization to prevent neurological deterioration and maintain alignment. Lateral mass screw fixation has emerged as a reliable technique for posterior cervical stabilization. This study evaluates the clinical and radiological outcomes of lateral mass screw fixation in patients with traumatic subaxial cervical spine injuries at the National Orthopaedic Hospital (NOH), Dala, Kano, Nigeria. Methods: A retrospective cohort study was conducted on patients who underwent posterior lateral mass screw fixation for traumatic cervical spine injuries (C3-C7) between January 2019 and December 2024 at NOH, Dala. Data extracted included demographics, mechanism of injury, levels instrumented, neurological status using Frankel grading, operative details, complications and fusion rates. Outcomes were assessed preoperatively and at 6 and 12 months postoperatively. Results: A total of 48 patients (38 males, 10 females) with a mean age of 41.2 ± 12.8 years (range: 19-68 years) underwent lateral mass screw fixation. Road traffic accidents were the predominant mechanism (81.3%). The most common level of injury was C5-C6 (47.9%). Mean operative time was 168 ± 42 minutes and mean blood loss was 320 ± 140 mL. At 12 months, 32 of 48 patients (66.7%) showed neurological improvement by at least one Frankel grade, with 12 patients (25.0%) achieving complete neurological recovery (Grade E). Fusion was achieved in 44 patients (91.7%). Complications occurred in 8 patients (16.7%), including superficial wound infection (6.3%), transient C5 radiculopathy (4.2%), screw malposition requiring revision (2.1%) and implant failure (2.1%). There was no vertebral artery injury or perioperative mortality. Conclusion: Lateral mass screw fixation for traumatic cervical spine injuries at NOH, Dala, demonstrates favourable neurological recovery, high fusion rates and acceptable complication rates, comparable to international series. These findings support the continued use of this technique in Nigerian tertiary centres for managing unstable subaxial cervical trauma.