Liu Guan-Yi, Xu Rong-Ming, Ma Wei-Hu, Sun Shao-Hua, Lin Hua-Jie, Feng Jian-Xiang, Hu Yong, Zhao Liu-Jun, Zhou Lei-Jie
Department of Orthopaedics, Ningbo Sixth People's Hospital, Ningbo, China.
Zhonghua Wai Ke Za Zhi. 2011 Feb 1;49(2):162-5. doi: 10.3760/cma.j.issn.0529-5815.2011.02.014.
To explore the feasibility and the technical parameters in posterior C2 spinous process laminar screw fixation, and discuss the clinic significance of C2 spinous process laminar screws.
Twenty cervical cadaveric spines of C2 were dissected, with care taken to expose the lamina and spinous process. After the entrance point of spinous process screw were determined, posterior C2 spinous process laminar screw implantation was performed under visual control. On the morphologic CT scan, the angle and length of the spinous process laminar screw trajectory and the distance between the tip of the screw and the spinal cord and the vertebral artery were measured.
The C2 spinous process laminar screws were successfully placed, without impingement of the spinal cord and the vertebral artery. There were little differences between superior and inferior screws in the angle, trajectory length and the distance between the tip of the screw and the spinal cord and the vertebral artery, but without significance (P > 0.05). The placed angles of the screws were 76.8° ± 10.6° in the axial plane. The distance between the tip of the screw and the spinal cord and the vertebral artery was (5.3 ± 1.6) mm and (17.4 ± 3.7) mm respectively. The trajectory length was (23.1 ± 3.2) mm.
Posterior C2 spinous process laminar screw fixation is feasible. C2 spinous process laminar screw fixation affords an alternative to standard screw placement for plate fixation and cervical stabilization.
探讨C2椎弓根螺钉后路固定的可行性及技术参数,并探讨C2椎弓根螺钉的临床意义。
解剖20个C2颈椎尸体标本,小心暴露椎板和棘突。确定棘突螺钉进针点后,在直视下进行C2椎弓根螺钉后路植入。在形态学CT扫描上,测量椎弓根螺钉轨迹的角度和长度以及螺钉尖端与脊髓和椎动脉之间的距离。
成功置入C2椎弓根螺钉,未出现脊髓和椎动脉损伤。上下螺钉在角度、轨迹长度以及螺钉尖端与脊髓和椎动脉之间的距离上差异不大,但无统计学意义(P>0.05)。螺钉在轴位平面的置入角度为76.8°±10.6°。螺钉尖端与脊髓和椎动脉之间的距离分别为(5.3±1.6)mm和(17.4±3.7)mm。轨迹长度为(23.1±3.2)mm。
C2椎弓根螺钉后路固定是可行的。C2椎弓根螺钉固定为钢板固定和颈椎稳定的标准螺钉置入提供了一种替代方法。