Ando Kei, Imagama Shiro, Ito Zenya, Kobayashi Kazuyoshi, Ukai Junichi, Muramoto Akio, Shinjo Ryuichi, Matsumoto Tomohiro, Nakashima Hiroaki, Nishida Yoshihiro, Ishiguro Naoki
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65-Tsurumai, Nagoya City, Aichi 466-8550, Japan.
J Orthop Surg Res. 2014 Jan 20;9:2. doi: 10.1186/1749-799X-9-2.
The purpose of this study was to describe the radiological outcomes in patients with unilateral instrumented fixation for cervical dumbbell tumors.
Fourteen consecutive individuals were included in the present study. We included Eden type II and III tumors in this cohort study and analyzed fixed segment fusion rates, screw failure with multiplanar reconstruction computed tomography (CT) scan radiographs and lateral radiographs with flexion-extension dynamic views, and immediate postoperative and last follow-up radiographs after surgery.
The mean follow-up was 105.4 months. There were six men and eight women ranging in age from 32 to 70 years (mean age, 48 years). Twenty pedicle screws (PSs) and 11 lateral mass screws (LMSs) were used in total. There were seven patients with only PSs, four with only LMSs, and three with PSs at C2 and LMSs at C3. PS misplacement occurred in three screws of insertions including two screws with grade 1 misplacement and one screw with grade 2 misplacement, and no grade 3 misplacement occurred. All screws breached the lateral wall with no apparent superior or inferior misplacement. None of the LMSs were misplaced. Fortunately, no complication could be directly attributed to screw insertion. Radiological evidence showed that all patients achieved successful fusion with no screw loosening or breakage. However, two patients who received only LMS fixation had degenerative spondylolisthesis at the upper fusion segment at the last follow-up.
Grade 2 PS misplacement occurred in one screw of insertions. Unilateral pedicle screw fixation for cervical dumbbell tumors is a useful surgical method that can successfully fuse vertebrae with good postoperative alignment.
本研究旨在描述单侧器械固定治疗颈椎哑铃形肿瘤患者的影像学结果。
本研究纳入了14例连续病例。在这项队列研究中，我们纳入了伊登II型和III型肿瘤，并分析了固定节段融合率、通过多平面重建计算机断层扫描（CT）片和屈伸动态位X线侧位片评估的螺钉失败情况，以及术后即刻和末次随访时的X线片。
平均随访时间为105.4个月。患者包括6名男性和8名女性，年龄在32至70岁之间（平均年龄48岁）。总共使用了20枚椎弓根螺钉（PS）和11枚侧块螺钉（LMS）。其中7例患者仅使用PS，4例仅使用LMS，3例患者在C2节段使用PS，在C3节段使用LMS。3枚植入的PS发生位置不当，其中2枚为1级位置不当，1枚为2级位置不当，未发生3级位置不当。所有螺钉均突破侧壁，无明显上下移位。所有LMS均未发生位置不当。幸运的是，没有并发症可直接归因于螺钉植入。影像学证据显示，所有患者均实现了成功融合，无螺钉松动或断裂。然而，2例仅接受LMS固定的患者在末次随访时，上融合节段出现了退变性椎体滑脱。
1枚植入的螺钉发生了2级PS位置不当。单侧椎弓根螺钉固定治疗颈椎哑铃形肿瘤是一种有效的手术方法，可成功实现椎体融合，术后对线良好。
