Smith Luke G F, Hoang Nguyen, Shaikhouni Ammar, Viljoen Stephanus
1Department of Neurological Surgery, Ohio State University, Wexner Medical Center; and.
2Division of Neurological Surgery, Nationwide Children's Hospital, Columbus, Ohio.
J Neurosurg Spine. 2019 Mar 1;30(6):772-776. doi: 10.3171/2018.12.SPINE181147. Print 2019 Jun 1.
Pedicle and lateral mass screws are the most common means of rigid fixation in posterior cervical spine fusions. Various other techniques such as translaminar screw placement, paravertebral foramen screw fixation, sublaminar and spinous process wiring, cement augmentation, and others have been developed for primary fixation or as salvage methods. Use of these techniques can be limited by a prior history of osteotomies, poor bone density, destruction of the bone-screw interface, and unfavorable vascular and osseous anatomy.Here, the authors report on the novel application of cervical sublaminar polyester bands as an adjunct salvage method or additional fixation point used with traditional methods in the revision of prior constructs. While sublaminar polyester bands have been used for decades in pediatric scoliosis surgery in the thoracolumbar spine, they have yet to be utilized as a method of fixation in the cervical spine. In both cases described here, sublaminar banding proved crucial for fixation points where traditional fixation techniques would have been less than ideal. Further study is required to determine the full application of sublaminar polyester bands in the cervical spine as well as its outcomes.
椎弓根螺钉和侧块螺钉是颈椎后路融合术中最常用的坚强固定方法。还开发了各种其他技术,如经椎板螺钉置入、椎旁孔螺钉固定、椎板下和棘突钢丝固定、骨水泥强化等,用于初次固定或作为挽救方法。这些技术的应用可能会受到既往截骨病史、骨密度差、骨-螺钉界面破坏以及不利的血管和骨质解剖结构的限制。在此,作者报告了颈椎椎板下聚酯带作为一种辅助挽救方法或与传统方法联合使用的额外固定点在翻修先前植入物中的新应用。虽然椎板下聚酯带在小儿胸腰椎脊柱侧弯手术中已使用数十年,但尚未被用作颈椎的固定方法。在本文所述的两个病例中,椎板下绑扎对于传统固定技术不太理想的固定点至关重要。需要进一步研究以确定椎板下聚酯带在颈椎中的全面应用及其效果。