Jeszenszky Dezso, Fekete Tamás Fülöp, Melcher Robert, Harms Jürgen
Schulthess Clinic, Spine Center, Lengghalde 2, 8008, Zurich, Switzerland.
Eur Spine J. 2007 Oct;16(10):1695-700. doi: 10.1007/s00586-007-0435-6. Epub 2007 Jul 14.
Destruction of the second cervical vertebra leads to a highly unstable situation. Reconstruction is difficult because the axis plays a central role in rotatory movements and has a unique function in redistributing axial loads. The axis transfers the axial load of the two lateral masses of the atlas to three surfaces on the third cervical vertebra: the two articular facets and the vertebral body. As reconstruction is difficult and the instability in this region is life threatening, pathological processes are often treated less radically compared to other areas of the cervical spine. However, this more moderate approach may result in worse outcomes and prognoses. This paper presents the development of a new implant (C2 prosthesis) and two illustrative cases describing the implementation of this new implant. The C2 prosthesis provides anterior support and therefore allows a more radical surgical approach.
第二颈椎的破坏会导致高度不稳定的情况。重建很困难,因为枢椎在旋转运动中起核心作用,并且在重新分配轴向负荷方面具有独特功能。枢椎将寰椎两侧块的轴向负荷传递至第三颈椎的三个表面:两个关节面和椎体。由于重建困难且该区域的不稳定性会危及生命,与颈椎的其他区域相比,病理过程的治疗往往不够彻底。然而,这种较为保守的方法可能会导致更差的结果和预后。本文介绍了一种新型植入物(C2假体)的研发以及两个说明该新型植入物应用情况的病例。C2假体提供前路支撑,因此允许采用更激进的手术方法。