Floyd T, Grob D
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Spine (Phila Pa 1976). 2000 Nov 15;25(22):2913-5. doi: 10.1097/00007632-200011150-00013.
This was a retrospective review of a new surgical technique.
To describe a new method of fixation augmentation in posterior C1-C2 spondylodesis.
Posterior atlantoaxial spondylodesis using transarticular screws is often supplemented with sublaminar wires to enhance stability. This technique is not possible if the arch of C1 is deficient. A method of stabilizing the segment and the graft was developed, and the early results were reviewed.
Five patients with a deficient posterior arch of the atlas, who also needed atlantoaxial spondylodesis, were reviewed. In each patient, fixation was augmented with translaminar screws that attached the graft to the arch of C1.
In all five patients, solid arthrodesis was achieved, and all had substantial relief of pain. There were no neurologic complications or failures of fixation.
The method of fixation of graft to the atlas using translaminar screws is a safe and reasonable alternative to external halo immobilization or more extensive surgery, such as occiput to C2 fusion.
这是一项对一种新手术技术的回顾性研究。
描述一种用于后路C1-C2椎间融合术的固定增强新方法。
使用经关节螺钉进行后路寰枢椎融合术时，常辅以椎板下钢丝以增强稳定性。如果C1椎弓缺如，则无法采用该技术。我们开发了一种稳定该节段和移植物的方法，并对早期结果进行了回顾。
对5例同时需要寰枢椎融合术且寰椎后弓缺如的患者进行了回顾性研究。在每例患者中，通过经椎板螺钉将移植物固定于C1椎弓，以增强固定效果。
所有5例患者均实现了坚固的融合，且疼痛均得到显著缓解。未发生神经并发症或固定失败。
使用经椎板螺钉将移植物固定于寰椎的方法，是一种安全合理的替代方案，可避免使用外固定架或进行如枕骨至C2融合等更广泛手术。
