Mendelsohn Daniel, Dea Nicolas, Lee Robert, Boyd Michael C
Department of Orthopaedics, Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia, Vancouver, BC, Canada.
Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK.
Asian Spine J. 2015 Oct;9(5):783-8. doi: 10.4184/asj.2015.9.5.783. Epub 2015 Sep 22.
Multiple techniques exist for the fixation of C2, including axial pedicle screws and bilateral translaminar screws. We describe a novel method of incorporating both the translaminar and pedicle screws within C2 to improve fixation to the subaxial spine in patients requiring posterior cervical instrumentation for deformity correction or instability. We report three cases of patients with cervical spinal instability, who underwent cervical spine instrumentation for stabilization and/or deformity correction. Bilateral C2 pedicle screws were inserted, followed by bilateral crossed laminar screws. The instrumentation method successfully achieved fixation in all three patients. There were no immediate postoperative complications, and hardware positioning was satisfactory. Instrumenting C2 with translaminar and pedicle screws is technically feasible, and it may improve fixation to the subaxial spine in patients with poor bone quality or severe subaxial deformity, which require a stronger instrumentation construct.
用于固定C2的技术有多种，包括轴向椎弓根螺钉和双侧经椎板螺钉。我们描述了一种将经椎板螺钉和椎弓根螺钉结合在C2内的新方法，以改善需要后路颈椎器械固定来矫正畸形或治疗不稳定的患者对下颈椎的固定。我们报告了3例颈椎不稳定患者，他们接受了颈椎器械固定以实现稳定和/或畸形矫正。先插入双侧C2椎弓根螺钉，然后是双侧交叉椎板螺钉。该器械固定方法在所有3例患者中均成功实现了固定。术后无即刻并发症，内固定位置满意。用经椎板螺钉和椎弓根螺钉固定C2在技术上是可行的，对于骨质较差或下颈椎严重畸形且需要更强器械固定结构的患者，这种方法可能会改善对下颈椎的固定。
