Wang Yue, Tang Liuyi, Hu Jiang
Department of Orthopedics, Sichuan Medical Science Academy & Sichuan Provincial People's Hospital, Chengdu Sichuan 610072, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Oct;21(10):1071-3.
To evaluate the fixation technique of using the cervical lateral mass plate in the cervical posterior approach operation.
Eight patients in this group were admitted from September 2001 to November 2006. Among the 8 patients, there were 6 males and 2 females, with their ages ranging from 28 to 78 years. Cervical vertebral fracture with dislocation was found in 4 patients, C2 spinal cord injury in 1, C1 fracture in 1, cervical spinal stenosis in 1, and C2-5 spinal cord neurofibroma in 1. Muscle strength 3-4. The Frankel grading system was used in 6 patients with traumatic injury. Before operation, Grade C was observed in 2 patients,Grade D in 3,and Grade E in 1. All the operations were performed according to requirements of the Margel's method. We positioned 40 screws in all the patients, including 4 screws at C2, 6 screws at C.3, 12 screws at C4, 4 screws at C5, 4 screws at C6. 2 screws at C7, and 6 screws at T1.
The following-up for an average of 14. 1 months (range, 6-45 months) revealed that there was no malposition of the screws in the patients. One of the 8 patients developed spinal instability in the fixed segment at 3 months after operation. The head-chest brace was applied to the patient for 3 months, and the spinal fusion was achieved. The further following-up to 45 months indicated that there was no instability occurring. The remaining patients recovered to their spinal stability by the spinal fusion. The patients also recovered in their neurological function after operation. The Frankel assessment showed that 1 patient had Grade E, 3 from Grade D to Grade E, 1 from Grade C to Grade D, and 1 from Grade C to Grade E.
The cervical lateral mass plate fixation can provide the immediate and strong segmental immobilization for the good cervical spine stability.
评估颈椎后路手术中使用颈椎侧块钢板的固定技术。
该组8例患者于2001年9月至2006年11月入院。8例患者中，男性6例，女性2例，年龄28至78岁。4例患者为颈椎骨折脱位，1例为C2脊髓损伤，1例为C1骨折，1例为颈椎管狭窄，1例为C2 - 5脊髓神经纤维瘤。肌力3 - 4级。6例创伤性损伤患者采用Frankel分级系统。术前，2例患者为C级，3例为D级，1例为E级。所有手术均按照Margel法的要求进行。所有患者共置入40枚螺钉，其中C2置入4枚螺钉，C3置入6枚螺钉，C4置入12枚螺钉，C5置入4枚螺钉，C6置入4枚螺钉，C7置入2枚螺钉，T1置入6枚螺钉。
平均随访14.1个月（范围6 - 45个月）显示，患者螺钉无错位。8例患者中有1例在术后3个月出现固定节段脊柱不稳。对该患者应用头胸支具3个月，实现了脊柱融合。进一步随访至45个月表明未再出现不稳。其余患者通过脊柱融合恢复了脊柱稳定性。患者术后神经功能也有所恢复。Frankel评估显示，1例患者为E级，3例从D级恢复至E级，1例从C级恢复至D级，1例从C级恢复至E级。
颈椎侧块钢板固定可为颈椎提供即时且强大的节段性固定，以实现良好的颈椎稳定性。
