{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:25:31Z","timestamp":1791044731046,"version":"4.1.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2007,8]]},"abstract":"<jats:sec>\n<jats:title>Object.<\/jats:title>\n<jats:p>Instability of the occipitocervical junction may result from degenerative disease, infection, tumor, and trauma. Surgical stabilization involving screw fixation and rigid implants has been found to be biomechanically superior to wire-based implants. To evaluate the long-term results in a large and diverse patient population, the authors prospectively studied a consecutive group of 69 patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods.<\/jats:title>\n<jats:p>All patients underwent occipitocervical fusion in which rigid posterior instrumentation included either plates or rods and screws. Patients ranged in age from 11 to 90 years (mean 51.4 years); there were 34 female and 35 male patients. The mean follow-up duration was 37 months (range 6\u201366 months). Fifty-seven (83%) of the 69 patients had long-standing occipitocervical anomalies, whereas the remainder presented with acute instability. Basilar invagination was present in 20 patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results.<\/jats:title>\n<jats:p>Correction of a severe cervical kyphotic deformity was accomplished in six patients. There were no fatalities or medical complications associated with the procedures. During the follow-up period, 87% of the patients exhibited improvement in their myelopathic symptoms; in 13% the symptoms were unchanged. Complications were minimal. Stability was demonstrated on flexion\/extension studies in all cases. There were no treatment-related deaths, although four patients died within the follow-up period, all due to progression of metastatic disease.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions.<\/jats:title>\n<jats:p>The authors found that rigid internal fixation of the occipitocervical complex was safe, effective, and technically possible for spine surgeons familiar with occipital bone anatomy and lateral mass fixation.<\/jats:p><\/jats:sec>","DOI":"10.3171\/spi-07\/08\/117","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T13:19:02Z","timestamp":1201180742000},"page":"117-123","source":"Crossref","is-referenced-by-count":89,"title":["Occipitocervical fusion with rigid internal fixation: long-term follow-up data in 69 patients"],"prefix":"10.3171","volume":"7","author":[{"given":"Russ P.","family":"Nockels","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington; and"},{"name":"Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Kanter","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Azeem","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie E.","family":"York","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0070117","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1097\/00007632-199607150-00004","article-title":"Threaded steinmann pin fusion of the craniovertebral junction","volume":"21","author":"Apostolides","year":"1996"},{"key":"b2-0070117","series-title":"J Neurosurg","first-page":"166","article-title":"Outcome in neurologically impaired patients with craniovertebral junction tuberculosis: results of combined anteroposterior surgery","volume":"97","author":"Arunkumar","year":"2002"},{"key":"b3-0070117","series-title":"Spine","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1097\/00007632-199703150-00004","article-title":"Comparative mechanical properties of spinal cable and wire fixation systems","volume":"22","author":"Dickman","year":"1997"},{"issue":"1 Suppl","key":"b4-0070117","series-title":"J Neurosurg","first-page":"135","article-title":"Inverted-hook occipital clamp system in occipitocervical fixation. 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