Tarukado Kiyoshi, Tono Osamu, Doi Toshio
Department of Orthopedic Surgery, Kyushu University Beppu Hospital, Oita, Japan.
Asian Spine J. 2015 Oct;9(5):789-93. doi: 10.4184/asj.2015.9.5.789. Epub 2015 Sep 22.
Four patients underwent stabilization surgery using both bilateral C2 pedicle screw (PS) and intralaminar screw (LS). Neural and vascular injury resulting from incorrect screw placement was assessed using computed tomography (CT). The evaluation of bone union was assessed by lateral flexion-extension X-ray films and CT. The symptoms were improved in all patients. There were no intraoperative complications. Furthermore, there were no cases of neurological worsening or vascular injury from incorrect screw placement. Failure of instrumentation or screw loosening during the follow-up period did not occur in any of the patients. All cases had accomplished bone union at the final follow-up. Theoretically, the stabilization technique using both bilateral C2 PS and LS at the same time can provide more stability than any other single technique. Simultaneous use of both bilateral C2 PS and LS is potentially a good choice for surgical repair.
4例患者接受了双侧C2椎弓根螺钉(PS)和椎板螺钉(LS)联合固定手术。使用计算机断层扫描(CT)评估螺钉置入不当导致的神经和血管损伤。通过侧方屈伸位X线片和CT评估骨愈合情况。所有患者症状均有改善。术中无并发症。此外,没有因螺钉置入不当导致神经功能恶化或血管损伤的病例。随访期间,所有患者均未出现内固定失败或螺钉松动的情况。所有病例在末次随访时均实现了骨愈合。理论上,同时使用双侧C2 PS和LS的固定技术比其他任何单一技术都能提供更高的稳定性。同时使用双侧C2 PS和LS可能是手术修复的一个不错选择。