枢椎螺钉：大量病例系列的结果与并发症
Axis screws: results and complications of a large case series.
作者信息
Formentin Cleiton, Andrade Erion Junior de, Maeda Fernando Luis, Ghizoni Enrico, Tedeschi Helder, Joaquim Andrei F
机构信息
Resident - Neurosurgery Division - Department of Neurology, University of Campinas (UNICAMP), Campinas-SP, Brasil.
Assistant Professor - Neurosurgery Division - University of Campinas (UNICAMP), Campinas-SP, Brasil.
出版信息
Rev Assoc Med Bras (1992). 2019 Feb;65(2):198-203. doi: 10.1590/1806-9282.65.2.198.
OBJECTIVE
To present the surgical results of patients who underwent axis screw instrumentation, discussing surgical nuances and complications of the techniques used.
METHODS
Retrospective case-series evaluation of patients who underwent spinal surgery with axis instrumentation using screws.
RESULTS
Sixty-five patients were included in this study. The most common cause of mechanical instability was spinal cord trauma involving the axis (36 patients - 55.4%), followed by congenital craniocervical malformation (12 patients - 18.5%). Thirty-seven (57%) patients required concomitant C1 fusion. Bilateral axis fixation was performed in almost all cases. Twenty-three patients (35.4%) underwent bilateral laminar screws fixation; pars screws were used in twenty-two patients (33.8%), and pedicular screws were used isolated in only three patients (4.6%). In fourteen patients (21.5%), we performed a hybrid construction. There was no neurological worsening nor vertebral artery injury in this series.
CONCLUSION
Axis screw instrumentation proved to be a safe and efficient method for cervical stabilization. Laminar and pars screws were the most commonly used.
目的
介绍接受枢椎螺钉内固定术患者的手术结果，探讨所用技术的手术细节及并发症。
方法
对接受枢椎螺钉内固定脊柱手术患者进行回顾性病例系列评估。
结果
本研究纳入65例患者。机械性不稳定的最常见原因是累及枢椎的脊髓损伤（36例患者 - 55.4%），其次是先天性颅颈畸形（12例患者 - 18.5%）。37例（57%）患者需要同时进行C1融合。几乎所有病例均行双侧枢椎固定。23例患者（35.4%）采用双侧椎板螺钉固定；22例患者（33.8%）使用关节突螺钉，仅3例患者（4.6%）单独使用椎弓根螺钉。14例患者（21.5%）采用混合结构。本系列中无神经功能恶化及椎动脉损伤情况。
结论
枢椎螺钉内固定术被证明是一种安全有效的颈椎稳定方法。椎板螺钉和关节突螺钉是最常用的。
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