Work

Combined lateral mass–transfacet fixation for subaxial cervical spondylosis: clinical outcomes and development of a prognostic nomogram

Year: 2026

Type: article

Abstract: Background To develop a nomogram for predicting postoperative neurological recovery in patients with subaxial cervical spondylosis and to compare the outcomes of conventional lateral mass fixation and combined lateral mass–transfacet fixation. Methods This single-center retrospective cohort study included 204 patients with subaxial cervical spondylosis who underwent conventional lateral mass or combined lateral mass–transfacet fixation. The primary endpoint was postoperative neurological recovery assessed using mJOA scores. Potential clinical, surgical, and radiological predictors were evaluated using univariable and multivariable logistic regression. Model discrimination and calibration were assessed, with internal validation performed using 1,000 bootstrap resamples. Results Of 204 patients, 78 underwent combined lateral mass–transfacet fixation. Multivariable logistic regression showed that surgical technique [OR = 18.03; 95% CI: 1.08–318.35; p = 0.042] and preoperative sagittal spinal canal diameter [OR = 0.59; 95% CI: 0.39–0.87; p = 0.010] were independently associated with postoperative neurological recovery. The final nomogram demonstrated good discrimination [AUC = 0.796; 95% CI: 0.729–0.862]. Bootstrap internal validation demonstrated limited optimism, with an optimism-corrected C-index of 0.797 and a corrected calibration slope of 0.961. Conclusions Combined lateral mass–transfacet fixation was associated with shorter operative times and favorable postoperative outcomes compared with conventional lateral mass fixation, suggesting that it may represent a feasible alternative for posterior cervical decompression and instrumented fixation in selected patients.

Source: Interdisciplinary Neurosurgery

DOI: 10.1016/j.inat.2026.102356

Authors: Fatma Betül Saylak, Oktay Gürcan, Atilla Kazancı, Gıyas Ayberk, Ahmet Gürhan Gürçay

Institution: Ankara Yıldırım Beyazıt University

Language: English

Topic: Cervical and Thoracic Myelopathy

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,910