Carelli Luis E, Girão Alderico, Cabrera Juan P
Center of Spine Diseases, Department of Orthopedics and Traumatology, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.
Faculty of Medicine, University of Concepción, Concepción, Chile.
J Craniovertebr Junction Spine. 2022 Apr-Jun;13(2):201-203. doi: 10.4103/jcvjs.jcvjs_168_21. Epub 2022 Jun 13.
Translaminar screws in the cervical spine have been mostly employed at C2 level when conventional trajectories are challenging. However, reports in the literature of translaminar screw of C1 are remarkably anecdotal. We aimed to report a case using C1 translaminar in addition to C1 lateral mass screws for the reinforcement of subaxial cervical spine reconstruction. We present a 22-year-old female patient, who developed persistent cervical pain, and computed tomography scan demonstrated lytic lesions of the vertebral bodies and lateral masses from C3 to C6. Magnetic resonance imaging showed spinal cord compression without myelopathy. Surgical biopsy was inconclusive, and an oncological vertebral instability led to surgical stabilization. Laminectomy and bilateral facetectomy of levels involved was achieved, instrumentation from C1 to T3 and reconstruction with posterolateral fibula bilaterally, and without occipital fixation. A third satellite rod was placed using C1-2-7 translaminar screws. Translaminar screw of C1 is a feasible alternative for increasing the strength of the construct.
当传统入路具有挑战性时，颈椎经椎板螺钉大多应用于C2节段。然而，文献中关于C1经椎板螺钉的报道非常少见。我们旨在报告1例除C1侧块螺钉外，使用C1经椎板螺钉加强下颈椎重建的病例。我们报告1例22岁女性患者，其持续存在颈部疼痛，计算机断层扫描显示C3至C6椎体和侧块溶骨性病变。磁共振成像显示脊髓受压但无脊髓病。手术活检结果不明确，肿瘤性椎体不稳导致手术固定。对受累节段进行了椎板切除和双侧小关节突切除，从C1至T3进行内固定，并双侧行后外侧腓骨重建，未行枕骨固定。使用C1-2-7经椎板螺钉放置第三根附加棒。C1经椎板螺钉是增强内固定强度的一种可行选择。
