Rhiew Richard, Manjila Sunil, Dezure Adam, Tabbosha Monir, Guthikonda Murali, Eltahawy Hazem
Department of Neurological Surgery, Wayne State University, Detroit, Michigan 48201, USA.
Neurosurg Focus. 2008;25(2):E4. doi: 10.3171/FOC/2008/25/8/E4.
The authors describe a technique for minimally invasive anterior vertebroplasty for treating metastatic disease of the C-2 vertebra and discuss its application in 2 cases. After a 2-cm lateral neck incision is made, blunt dissection is performed toward the anterior inferior endplate of the C-2 vertebra. An 11-gauge needle is introduced through a tubular sheath and tapped into the inferior endplate of C-2, with biplanar fluoroscopy being performed to confirm position. The needle is subsequently advanced across the fracture line and into the odontoid process. Under fluoroscopic guidance, 2 ml of methylmethacrylate is injected into the odontoid process and vertebral body. This method is advantageous as 1) hyperextension of the neck is not performed, 2) the chance of inadvertent neurovascular or submandibular gland injury is minimized, 3) the possibility of cement leakage is decreased, and 4) hemostasis is better achieved under direct vision.
作者描述了一种用于治疗C2椎体转移性疾病的微创前路椎体成形术技术，并讨论了其在2例患者中的应用。在颈部外侧做一个2厘米的切口后，朝着C2椎体的前下终板进行钝性分离。通过一个管状鞘插入一根11号针，并轻敲进入C2的下终板，同时进行双平面荧光透视以确认位置。随后将针推进穿过骨折线并进入齿突。在荧光透视引导下，将2毫升甲基丙烯酸甲酯注入齿突和椎体。该方法具有以下优点：1）无需进行颈部过伸；2）将意外神经血管或下颌下腺损伤的几率降至最低；3）减少了骨水泥渗漏的可能性；4）在直视下能更好地实现止血。
