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Peer-reviewedCC BY-NC-SASurgical neurology international

Technical refinement of semispinalis cervicis-preserving occipitocervical fixation for rheumatoid arthritis/basilar invagination.

  • Kaoru Eguchi1
  • Yu Sugiyama1
  • Ryo Ando1
  • Masashi Ito1
  • Satoshi Maesawa1
  1. 1Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
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Abstract

Background

Conventional occipitocervical (O-C) fixation for rheumatoid arthritis (RA)-associated basilar invagination (BI) may require extensive dissection and detachment of the posterior cervical extensor musculature. As this included the semispinalis cervicis (SSC), it may result in significant postoperative axial neck pain. Here, we describe a technical refinement of O-C fixation that preserves the SSC distal to its C2 attachment.Case description

A 48-year-old female presented with RA-associated BI and C4/5 spondylolisthesis. A posterior O-C to C5 fixation utilized an intermuscular dissection plane between the SSC and semispinalis capitis. Utilizing 3-D navigation, this allowed for exposure of the subaxial screw entry points while preserving the SSC caudal to C2, and ensured accurate screw placement. Postoperatively, at 8 postoperative months, her axial neck pain improved (i.e., visual analog scale 6-1), bridging bone indicated solid fusion, while the magnetic resonance confirmed indirect adequate neural decompression without SSC atrophy.Conclusion

This SSC-preserving O-C-C5 fixation technique achieved successful fusion in this case while avoiding postoperative axial neck pain and SSC atrophy.

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Cite

BibTeXRIS
BibTeX
@article{eguchi2026technical,
  title = {{Technical refinement of semispinalis cervicis-preserving occipitocervical fixation for rheumatoid arthritis/basilar invagination.}},
  author = {Kaoru Eguchi and Yu Sugiyama and Ryo Ando and Masashi Ito and Satoshi Maesawa},
  journal = {Surgical neurology international},
  year = {2026},
  month = oct,
  doi = {10.25259/sni_862_2026},
  url = {https://europepmc.org/article/MED/42974241},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Technical refinement of semispinalis cervicis-preserving occipitocervical fixation for rheumatoid arthritis/basilar invagination.
AU  - Kaoru Eguchi
AU  - Yu Sugiyama
AU  - Ryo Ando
AU  - Masashi Ito
AU  - Satoshi Maesawa
PY  - 2026
DA  - 2026/10/02
JO  - Surgical neurology international
DO  - 10.25259/sni_862_2026
UR  - https://europepmc.org/article/MED/42974241
AB  - Background  Conventional occipitocervical (O-C) fixation for rheumatoid arthritis (RA)-associated basilar invagination (BI) may require extensive dissection and detachment of the posterior cervical extensor musculature. As this included the semispinalis cervicis (SSC), it may result in significant postoperative axial neck pain. Here, we describe a technical refinement of O-C fixation that preserves the SSC distal to its C2 attachment.Case description  A 48-year-old female presented with RA-associated BI and C4/5 spondylolisthesis. A posterior O-C to C5 fixation utilized an intermuscular dissection plane between the SSC and semispinalis capitis. Utilizing 3-D navigation, this allowed for exposure of the subaxial screw entry points while preserving the SSC caudal to C2, and ensured accurate screw placement. Postoperatively, at 8 postoperative months, her axial neck pain improved (i.e., visual analog scale 6-1), bridging bone indicated solid fusion, while the magnetic resonance confirmed indirect adequate neural decompression without SSC atrophy.Conclusion  This SSC-preserving O-C-C5 fixation technique achieved successful fusion in this case while avoiding postoperative axial neck pain and SSC atrophy.
SN  - 2229-5097
SN  - 2152-7806
ER  -