Al Barbarawi Mohammed M, Allouh Mohammed Z
a Division of Neurosurgery, Department of Neuroscience , Faculty of Medicine, Jordan University of Science and Technology , Irbid , Jordan.
b Department of Anatomy , Faculty of Medicine, Jordan University of Science and Technology, Irbid , Jordan.
Br J Neurosurg. 2015;29(5):699-704. doi: 10.3109/02688697.2015.1026798. Epub 2015 Apr 20.
Posterior lateral mass screw-rod fixation is a common procedure in patients who undergo multilevel cervical spine laminectomy. It has been widely used in the last decade due to its ease of application and better biomechanical stability when compared with other techniques. However, the main risk remains the possibility of violating the spinal nerve root, vertebral artery, and/or facet joint.
This study reviews the short- and long-term outcomes of patients who underwent posterior cervical screw-rod stabilisation using the Anderson-Sekhon technique. It investigates the safety and reliability of this technique in one of the largest reported case series.
Both clinical and radiological indicators were retrospectively assessed in lateral mass fixation patients who were treated with the Anderson-Sekhon technique for screw insertion and trajectory. The sample included 430 patients with different cervical spine disorders who were treated with a total of 2500 lateral mass polyaxial screws from December 2005 until January 2014. Follow-up period ranged from 4 months to 8 years. No neural or vascular injury occurred. Twelve patients had wound infection, of whom 6 had deep infection. Twenty patients had C5 radicular pain that subsided over time; 2 required C5 screw modification; and another 3 required screw repositioning at different levels. Two patients had asymptomatic screw pull-out evident only on radiographs and required no treatment. Iatrogenic dural tear occurred in 12 patients with severe spondylosis, while CSF leakage from the tear was observed in 3 patients. Symptomatic adjacent segment disease was noted in 4 patients within the follow-up period and was treated with surveillance.
Lateral mass screw-rod stabilisation using the Anderson-Sekhon technique can be applied safely and effectively for various cervical spine diseases, resulting in a low complication rate and favourable short- and long-term outcomes.
后路侧块螺钉-棒固定术是接受多节段颈椎椎板切除术患者的常见手术。与其他技术相比，由于其操作简便且生物力学稳定性更好，在过去十年中已被广泛应用。然而，主要风险仍然是侵犯脊神经根、椎动脉和/或小关节的可能性。
本研究回顾了采用安德森-塞孔技术进行颈椎后路螺钉-棒稳定术患者的短期和长期疗效。在已报道的最大病例系列之一中，研究该技术的安全性和可靠性。
对采用安德森-塞孔技术进行螺钉置入和轨迹的侧块固定患者的临床和影像学指标进行回顾性评估。样本包括430例患有不同颈椎疾病的患者，从2005年12月至2014年1月共置入2500枚侧块多轴螺钉。随访时间为4个月至8年。未发生神经或血管损伤。12例患者发生伤口感染，其中6例为深部感染。20例患者出现C5神经根性疼痛，随时间推移症状缓解；2例需要调整C5螺钉；另外3例需要在不同节段重新定位螺钉。2例患者仅在X线片上显示无症状螺钉拔出，无需治疗。12例严重颈椎病患者发生医源性硬脊膜撕裂，其中3例观察到脑脊液从撕裂处漏出。随访期间4例患者出现症状性相邻节段疾病，予以观察处理。
采用安德森-塞孔技术的侧块螺钉-棒稳定术可安全有效地应用于各种颈椎疾病，并发症发生率低，短期和长期疗效良好。
