Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.
Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.
World Neurosurg. 2021 Jul;151:102-109. doi: 10.1016/j.wneu.2021.04.081. Epub 2021 Apr 30.
The Mayfield skull clamp is the most commonly used 3-pin head immobilization device. It is routinely used in cranial neurosurgical procedures and selected cervical procedures. Despite its role in some serious complications, guidelines and nuances on the correct application of the Mayfield clamp are lacking. The goal of this article was to present an overview of the complications associated with the Mayfield skull clamp. We also present a conceptual framework of the correct use-in our opinion-of the Mayfield clamp in several standard approaches to avoid the most common complications.
PubMed was searched for original articles published between 1980 and 2020 with the search terms "Mayfield skull clamp" and "Mayfield head clamp." Eligibility criteria were availability of English abstract and complications clearly attributed to the Mayfield skull clamp. Both authors assessed all search results for eligibility. Additional articles were found with cross-references.
The most common complications associated with Mayfield clamp application were due to vascular injury inflicted by the pins or skull fractures. Complications related to use of the Mayfield clamp were rare but often serious and avoidable. A conceptual framework was presented on how to avoid these complications.
Attention to detail, anatomy, and the primum non nocere principle are imperative in every step of the neurosurgical pathway, including placement of the Mayfield skull clamp. Thoughtful application, taking into consideration several nuances, is recommended to avoid inadvertent patient harm.
Mayfield 颅骨夹是最常用的 3 针头部固定装置。它通常用于颅神经外科手术和选择性颈椎手术。尽管它在一些严重并发症中发挥作用，但缺乏关于正确应用 Mayfield 夹的指南和细微差别。本文的目的是概述与 Mayfield 颅骨夹相关的并发症。我们还提出了一个正确使用 Mayfield 夹的概念框架，在几种标准方法中使用，以避免最常见的并发症。
在 1980 年至 2020 年期间，通过搜索术语“Mayfield 颅骨夹”和“Mayfield 头夹”，在 PubMed 上搜索了原始文章。纳入标准为是否有英文摘要以及并发症是否明确归因于 Mayfield 颅骨夹。两位作者均对所有搜索结果进行了评估。通过交叉引用找到了其他文章。
Mayfield 夹应用最常见的并发症是由于针或颅骨骨折造成的血管损伤。与使用 Mayfield 夹相关的并发症很少见，但往往很严重且可避免。提出了一个避免这些并发症的概念框架。
在神经外科手术的每一个步骤中，包括放置 Mayfield 颅骨夹，都需要注意细节、解剖结构和“首要原则”。建议在应用时要深思熟虑，考虑到几个细微差别，以避免无意中对患者造成伤害。
