Lin Hua-jie, Xu Rong-min, Liu Guan-yi
Zhejicmg University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China.
Zhongguo Gu Shang. 2011 Jun;24(6):530-3.
So far, the fixation in the lower cervical spine through posterior approach technology has commonly been used, besides the lateral screw and pedicle screw techniques, transarticular screw and laminar screw techniques have being paid more attention recently. This article introduced four screw fixation ways in the lower cervical spine through posterior approach and reviewed the recent biomechanics studies of four screw fixation techniques. The biomechanics study includes stabilization, pollout strength, insertion technique, and screw characteristic and so on. Lateral screw and pedicle screw techniques have become an effective internal fixation way for the lower cervical spine instability because of their superior stabilization and higher pollout strength. Transarticular screw fixation has become a new way to fix the lower cervical spine through posterior approach, which has widely surgical indications. Besides, this technique is relatively safe, simple and has achieved favorable curative effect in clinic. Laminar screw fixation technique is rarely used in clinic, but the study of anatomy and biomechanics confirmed that this technique can be applied as a salvage technique in clinic. Above four techniques of the screw fixation in the lower cervical spine through posterior approach have advantages and disadvantages, respectively, and the application in clinic is different. Through the biomechanics study of these techniques will contribute to the development of the techniques of the screw fixation in the lower cervical spine through posterior approach and guide the clinical work effectively.
目前，下颈椎后路固定技术应用较为普遍，除侧块螺钉和椎弓根螺钉技术外，关节突螺钉和椎板螺钉技术近年来也备受关注。本文介绍了下颈椎后路四种螺钉固定方法，并对四种螺钉固定技术的近期生物力学研究进行了综述。生物力学研究包括稳定性、拔出强度、置入技术及螺钉特性等。侧块螺钉和椎弓根螺钉技术因其卓越的稳定性和较高的拔出强度，已成为治疗下颈椎不稳的有效内固定方法。关节突螺钉固定已成为下颈椎后路固定的新方法，具有广泛的手术适应证。此外，该技术相对安全、操作简单，临床疗效良好。椎板螺钉固定技术在临床上应用较少，但解剖学和生物力学研究证实，该技术可作为一种补救技术应用于临床。上述下颈椎后路四种螺钉固定技术各有优缺点，临床应用也有所不同。对这些技术进行生物力学研究将有助于下颈椎后路螺钉固定技术的发展，并有效指导临床工作。
