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后路颈椎减压椎板切除术及侧块螺钉固定术

Posterior cervical decompressive laminectomy and lateral mass screw fixation.

作者信息

Audat Ziad A, Barbarawi Mohamed M, Obeidat Moutasem M

机构信息

Departments of Orthopedics, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Neurosciences (Riyadh). 2011 Jul;16(3):248-52.

Abstract

OBJECTIVE

To review the results and complications of cervical decompressive laminectomy and lateral mass screw fixation.

METHODS

This retrospective study was carried out between October 2006 and January 2010 at King Abdullah University Hospital, Irbid, Jordan. Over 40 months, 405 lateral mass screws were placed in 50 patients aged 22-65 years (17 females, and 33 males) for variable cervical pathologies including degenerative disease, trauma, and neoplasm. All cases were performed with a polyaxial screw/rod construct. Most patients had 14 mm length and 3.5 mm diameter screws placed. The screw location was evaluated by postoperative plain x-ray and CT. The facet joint, foraminal and foramen transversarium violation were also assessed.

RESULTS

All screws were placed using the Anderson or Sekhon methods. No patients experienced neural or vascular injury as a result of screw position. One patient needed screw repositioning. Three patients experienced superficial wound infection. Five patients experienced pain around the shoulder of C5 distribution that subsided over time. No patients had screw pullouts or symptomatic adjacent segment disease. Postoperative CT scanning showed no compromise of the foramen transversarium or neural foramen in the vast majority of the patients.

CONCLUSION

Lateral mass screw stabilization is a safe and effective surgical technique. This study exhibits the safety and effectiveness of lateral mass fixation for a variety of subaxial cervical spine disease.

摘要

目的

回顾颈椎减压椎板切除术及侧块螺钉固定术的结果与并发症。

方法

这项回顾性研究于2006年10月至2010年1月在约旦伊尔比德的阿卜杜拉国王大学医院开展。在40个月的时间里,为50例年龄在22至65岁之间的患者(17名女性和33名男性)置入了405枚侧块螺钉,用于治疗包括退行性疾病、创伤和肿瘤在内的多种颈椎病变。所有病例均采用多轴螺钉/棒结构。大多数患者置入的是长度为14毫米、直径为3.5毫米的螺钉。通过术后X线平片和CT评估螺钉位置。同时评估小关节、椎间孔和横突孔侵犯情况。

结果

所有螺钉均采用安德森或塞孔方法置入。没有患者因螺钉位置导致神经或血管损伤。1例患者需要重新调整螺钉位置。3例患者发生浅表伤口感染。5例患者在C5分布区域肩部周围出现疼痛,随时间推移症状缓解。没有患者出现螺钉拔出或有症状的相邻节段疾病。术后CT扫描显示绝大多数患者的横突孔或神经孔未受影响。

结论

侧块螺钉固定是一种安全有效的手术技术。本研究展示了侧块固定治疗各种下颈椎疾病的安全性和有效性。

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