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颈椎减压性椎板切除术及侧块螺钉-棒关节融合术。手术分析与结果。

Decompressive cervical laminectomy and lateral mass screw-rod arthrodesis. Surgical analysis and outcome.

作者信息

Al Barbarawi Moh'd M, Audat Ziad A, Obeidat Moutasem M, Qudsieh Tareq M, Dabbas Waleed F, Obaidat Mouness H, Malkawi Anas A

机构信息

Department of Neuroscience/ Division of Neurosurgery, Level 7A, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid-Amman Street, P,O,box 3030, Irbid, Jordan.

出版信息

Scoliosis. 2011 May 19;6:10. doi: 10.1186/1748-7161-6-10.

Abstract

BACKGROUND

This study evaluates the outcome and complications of decompressive cervical Laminectomy and lateral mass screw fixation in 110 cases treated for variable cervical spine pathologies that included; degenerative disease, trauma, neoplasms, metabolic-inflammatory disorders and congenital anomalies.

METHODS

A retrospective review of total 785 lateral mass screws were placed in patients ages 16-68 years (40 females and 70 males). All cases were performed with a polyaxial screw-rod construct and screws were placed by using Anderson-Sekhon trajectory. Most patients had 12-14-mm length and 3.5 mm diameter screws placed for subaxial and 28-30 for C1 lateral mass. Screw location was assessed by post operative plain x-ray and computed tomography can (CT), besides that; the facet joint, nerve root foramen and foramen transversarium violation were also appraised.

RESULTS

No patients experienced neural or vascular injury as a result of screw position. Only one patient needed screw repositioning. Six patients experienced superficial wound infection. Fifteen patients had pain around the shoulder of C5 distribution that subsided over the time. No patients developed screw pullouts or symptomatic adjacent segment disease within the period of follow up.

CONCLUSION

decompressive cervical spine laminectomy and Lateral mass screw stabilization is a technique that can be used for a variety of cervical spine pathologies with safety and efficiency.

摘要

背景

本研究评估了110例因各种颈椎病变接受减压性颈椎椎板切除术和侧块螺钉固定术的患者的手术结果及并发症,这些病变包括退行性疾病、创伤、肿瘤、代谢性炎症疾病和先天性异常。

方法

回顾性分析了共785枚侧块螺钉植入16至68岁患者(40名女性和70名男性)的情况。所有病例均采用多轴螺钉-棒结构,螺钉通过安德森-塞孔轨迹置入。大多数患者在颈椎下节段置入长度为12 - 14毫米、直径为3.5毫米的螺钉,C1侧块置入28 - 30毫米的螺钉。术后通过X线平片和计算机断层扫描(CT)评估螺钉位置,此外,还评估了小关节、神经根孔和横突孔的侵犯情况。

结果

没有患者因螺钉位置导致神经或血管损伤。只有1例患者需要重新调整螺钉位置。6例患者发生浅表伤口感染。15例患者在C5分布区域肩部周围出现疼痛,随着时间推移疼痛缓解。在随访期间,没有患者出现螺钉拔出或有症状的相邻节段疾病。

结论

减压性颈椎椎板切除术和侧块螺钉固定术是一种可安全、有效地用于多种颈椎病变的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e7/3113742/0212f40f9dfd/1748-7161-6-10-1.jpg

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