Transfacet screw placement for posterior fixation of C-7: Technical note

Eric M. Horn, Nicholas Theodore, Neil R. Crawford, Nicholas C. Bambakidis, Volker K.H. Sonntag

Research output: Contribution to journalArticle

18 Scopus citations


Object. Lateral mass screws are traditionally used to fixate the subaxial cervical spine, while pedicle screws are used in the thoracic spine. Lateral mass fixation at C-7 is challenging due to thin facets, and placing pedicle screws is difficult due to the narrow pedicles. The authors describe their clinical experience with a novel technique for transfacet screw placement for fixation at C-7. Methods. A retrospective chart review was undertaken in all patients who underwent transfacet screw placement at C-7. The technique of screw insertion was the same for each patient. Polyaxial screws between 8- and 10-mm-long were used in each case and placed through the facet from a perpendicular orientation. Postoperative radiography and clinical follow-up were analyzed for aberrant screw placement or construct failure. Results. Ten patients underwent C-7 transfacet screw placement between June 2006 and March 2007. In all but 1 patient screws were placed bilaterally, and the construct lengths ranged from C-3 to T-5. One patient with a unilateral screw had a prior facet fracture that precluded bilateral screw placement. There were no intraoperative complications or screw failures in these patients. After an average of 6 months of follow-up there were no hardware failures, and all patients showed excellent alignment. Conclusions. The authors present the first clinical demonstration of a novel technique of posterior transfacet screw placement at C-7. These results provide evidence that this technique is safe to perform and adds stability to cervicothoracic fixation.

Original languageEnglish (US)
Pages (from-to)200-206
Number of pages7
JournalJournal of Neurosurgery: Spine
Issue number2
StatePublished - Aug 1 2008


  • Cervical fusion
  • Lateral mass
  • Spinal fixation
  • Spine trauma

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

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    Horn, E. M., Theodore, N., Crawford, N. R., Bambakidis, N. C., & Sonntag, V. K. H. (2008). Transfacet screw placement for posterior fixation of C-7: Technical note. Journal of Neurosurgery: Spine, 9(2), 200-206.