الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The oldest and simplest form of mid-cervical instrumentation is spinous process wiring. There are a number of wiring strategies but all of them function on a tension band principle and are non rigid, they afford good stability on flexion but are less stable in other planes of motion especially extension. Wiring procedures are employed for facet dislocation, tear drop fractures, and postlaminectomy instabilities. Midline wiring should be avoided in the presence of spinous process or lamina fracture or in patients with marked tortional or sagital instabilities. Rigid posterior cervical instrumentation options include lateral mass screws, pedicle screws, and hooks. Lateral mass screws are more clearly indicated when wiring is mechanically inadequate as burst fracture. Safe lateral mass screw placement requires familiarity with the articular pillar anatomy. Pedicle screws offer three column fixation. They have greater pullout strength than lateral mass screws, but are technically more challenging and engender greater risk to the vertebral artery and nerve roots.