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Lateral mass screw fixation is now the surgical procedure of choice for stabilizing the cervical spine in the treatment of patients with cervical instability. Several techniques have been proposed for safe rigid fixation. We describe a simple and reliable method for lateral mass screw fixation using an original device of our own design. Using this device under fluoroscopic assistance, the lateral mass screw is directed at an angle 25 degrees laterally and dorsally just until it meets the posterior ridge of the transverse process of the cervical spine. Over the past seven years between 2002 and 2008, lateral mass screw fixation was performed in a total of 26 patients with cervical instability in our situation. Our unique method was applied to 15 of those 26 patients, including 11 men and 4 women ranging in age from 37 to 84 years old. Retrospective analysis demonstrated that there were no surgical complications, such as screw malposition resulting in vascular or neural damage. We discuss our surgical method for lateral mass screw fixation, concentrating on the avoidance and management of complication. (Received:August 31, 2008;accepted:October 20, 2008)

Lateral Mass Screw Fixation for Stabilization of the Middle and Lower Cervical Spine : Avoidance and Management of Complications