通过并发症和双皮质固定情况对三种不同颈椎侧块螺钉固定技术进行比较分析:尸体研究

Comparative analysis of three different cervical lateral mass screw fixation techniques by complications and bicortical purchase : cadaveric study.

作者信息

Baek Jin-Wook, Park Dong-Mook, Kim Dae-Hyun

机构信息

Department of Neurosurgery, Daegu Catholic University, College of Medicine, Daegu, Korea.

出版信息

J Korean Neurosurg Soc. 2010 Sep;48(3):193-8. doi: 10.3340/jkns.2010.48.3.193. Epub 2010 Sep 30.

Abstract

OBJECTIVE

The purpose of this study is to compare the incidence of possible complications of cervical lateral screw fixation and the achievements of bicortical purchase using the Roy-Camille, Magerl and the modified methods.

METHODS

Six fresh-frozen cervical spine segments were harvested. The Roy-Camille technique was applied to C3 and C4, and the Magerl technique was applied to C5, C6, and C7 of one side of each cadaver. The modified technique was applied to the other side of each cadaver. The nerve root injury, violation of the facet joint, vertebral artery injury, and the bicortication were examined at each screwing level.

RESULTS

No vertebral artery injury was observed in any of the three methods. One nerve root injury was observed in each cervical spine segment using the Roy-Camille method (8.3%), the Magerl method (5.6%), and the modified method (3.3%). Facet joint injuries were observed in two cervical spinal segments using the Roy-Camille method (16.7%) and three with the Magerl method (16.7%), while five facet joint violations occurred when using the modified method (16.7%). Bicortical purchases were achieved on ten cervical spinal segments with the Roy-Camille method (83.3%) and Magerl method (55.6%), while twenty bicortical purchases were achieved in the modified method (66.7%).

CONCLUSION

The advantages of the modified method are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known methods. This modified method can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

摘要

目的

本研究旨在比较颈椎侧方螺钉固定可能出现的并发症发生率,以及使用Roy-Camille法、Magerl法和改良法实现双皮质固定的情况。

方法

获取六个新鲜冷冻的颈椎节段。将Roy-Camille技术应用于每个尸体一侧的C3和C4,将Magerl技术应用于C5、C6和C7。将改良技术应用于每个尸体的另一侧。在每个拧入螺钉的节段检查神经根损伤、小关节侵犯、椎动脉损伤和双皮质固定情况。

结果

三种方法均未观察到椎动脉损伤。使用Roy-Camille法(8.3%)、Magerl法(5.6%)和改良法(3.3%)时,每个颈椎节段均观察到1例神经根损伤。使用Roy-Camille法(16.7%)观察到2个颈椎节段出现小关节损伤,使用Magerl法观察到3个颈椎节段出现小关节损伤(16.7%),而使用改良法时出现5个颈椎节段小关节侵犯(16.7%)。使用Roy-Camille法(83.3%)和Magerl法(55.6%)在10个颈椎节段实现了双皮质固定,而改良法在20个颈椎节段实现了双皮质固定(66.7%)。

结论

改良法的优点在于利用特定的解剖结构进行操作,且并发症发生率与其他已知方法一样低。这种改良法无需透视辅助即可轻松、安全地用于治疗多种颈椎疾病。

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