Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, PR China.
BMC Musculoskelet Disord. 2022 Feb 24;23(1):176. doi: 10.1186/s12891-022-05136-9.
Our research was designed to decide whether the application of C2 pars screws is an alternative choice for patients with OPLL involving the C2 segment.
A total of 40 patients who underwent cervical laminectomy with fusion (LF) from C2 to C6 for OPLL were reviewed. Among them, C2 pedicle screws were placed in 23 patients, who were the pedicle group, and C2 pars screws were placed in 17 patients, who were the pars group. The screw placement and vertebral artery (VA) anatomy presented by standard CT. General clinical characteristics and health-related outcomes were evaluated and compared preoperatively and during the follow-up period.
The Pars group tended to have a shorter operation duration and less blood loss than the pedicle group (operation time: 115.29 ± 28.75 vs 133.48 ± 26.22, p = 0.044; blood loss: 383.53 ± 116.19 vs 457.83 ± 145.45, p = 0.039). Operation time and blood loss were both independently related to the pars group (operation time: OR = 0.966, p = 0.021; blood loss: OR = 0.993, p = 0.046). The idealization and acceptability of C2 screws in the pars group exceeded those in the pedicle group (100% vs 91.3%). However, no statistically obvious variation in the included complications or health-related outcomes between the pedicle and pars groups was observed.
In the treatment of patients with OPLL involving the C2 segment, the application of C2 pars screws is an alternative choice, which is not only safer but also reduces the amount of blood loss, shortens the operation time and obtains a more ideal screw placement.
本研究旨在探讨颈椎后纵韧带骨化(OPLL)累及 C2 节段患者应用 C2 椎弓根螺钉是否为一种可行的选择。
回顾性分析了 40 例行颈椎后路单开门椎管扩大成形术(C2 至 C6)治疗 OPLL 的患者。其中,23 例行 C2 椎弓根螺钉固定术(椎弓根组),17 例行 C2 椎板螺钉固定术(椎板组)。通过标准 CT 评估螺钉的位置和椎动脉(VA)解剖结构。分别于术前和随访时评估并比较两组患者的一般临床特征和健康相关结局。
椎板组的手术时间和术中出血量均明显少于椎弓根组(手术时间:115.29±28.75 比 133.48±26.22,p=0.044;术中出血量:383.53±116.19 比 457.83±145.45,p=0.039)。手术时间和术中出血量与椎板组相关(手术时间:OR=0.966,p=0.021;术中出血量:OR=0.993,p=0.046)。椎板组螺钉的理想置钉率和可接受率均明显高于椎弓根组(100%比 91.3%)。但两组患者并发症的发生率和健康相关结局的差异均无统计学意义。
在治疗累及 C2 节段的 OPLL 患者时,C2 椎板螺钉的应用是一种可行的选择,它不仅更安全,还可减少出血量、缩短手术时间,获得更理想的螺钉置钉。