Weiland D J, McAfee P C
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Spinal Disord. 1991 Mar;4(1):15-21.
One hundred consecutive patients were treated by the triple-wire stabilization and fusion technique for acute cervical trauma (36 patients), rheumatoid arthritis (27 patients), degenerative osteoarthritis (20 patients), congenital deformities (13 patients), or neoplasms (11 patients). The triple wire technique developed by Bohlman is versatile enough to be used at any level of the cervical spine, with 60 patients undergoing subaxial fusions, 20 with atlantoaxial fusions, and 20 with stabilization to the occiput. The immediate stability is evidenced by the fact that only two of 60 subaxial triple-wire stabilizations required the use of a Halovest, 58 being managed postoperatively in two-poster orthosis. The fusion rate was 100% for subaxial fusions. The only pseudarthrosis occurred in an occiput to C2 triple wire fixation procedure, which was managed nonoperatively. There were no iatrogenic neurologic complications, unlike the use of techniques utilizing sublaminar wires, and there were no cervical infections.
连续100例患者接受三线固定融合技术治疗,病因包括急性颈椎创伤(36例)、类风湿性关节炎(27例)、退行性骨关节炎(20例)、先天性畸形(13例)或肿瘤(11例)。Bohlman研发的三线技术通用性强,可用于颈椎的任何节段,其中60例患者接受下颈椎融合术,20例接受寰枢椎融合术,20例接受枕骨固定术。60例下颈椎三线固定术中仅2例需要使用头环背心,58例术后采用双柱支具治疗,这一事实证明了该技术具有即时稳定性。下颈椎融合术的融合率为100%。唯一的假关节发生在枕骨至C2三线固定手术中,采用非手术方法处理。与使用椎板下钢丝技术不同,该技术未出现医源性神经并发症,也未发生颈椎感染。