Cechin Igor Ebert, Barros Alderico Girão Campos De, Khan Ahsan Ali, Silva Luis Eduardo Carelli Teixeira Da
Department of Spine Surgery, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.
Section of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
J Craniovertebr Junction Spine. 2023 Jul-Sep;14(3):299-305. doi: 10.4103/jcvjs.jcvjs_19_23. Epub 2023 Sep 18.
Placement of pedicle screw in the subaxial cervical spine is a challenging and complex technique but provides significant biomechanical advantages. Despite its potential complications, the role and use of cervical pedicle screw (CPS) are growing. A literature review of the significant articles on applying pedicle screws in the subaxial cervical spine was done (articles between 1994 and 2020). Furthermore, our center´s experience of 15 years related to CPS is also discussed in this study. Transpedicular instrumentation in the subaxial cervical spine requires profound anatomical knowledge and meticulous surgical technique. This technique provides superior biomechanical stability compared to the other cervical fixation techniques. Pull-out strength of CPS is twice as compared to the lateral mass screws. There have been numerous variations in the technique of CPS, varying from open techniques to minimally invasive and the use of biomodels and templates during this procedure. Clinically, CPS can be used in different cervical trauma situations, such as fracture-dislocations, floating lateral mass, and fractures associated with ankylosing spondylitis. Despite the possibility of neurovascular injury due to the proximity of the vertebral artery, spinal cord, and spinal nerves to the cervical pedicles, scientific literature, and our center × s experience show low risk, and this technique can be performed safely. CPS placement is a safe procedure, and it has great potential in the management of cervical spine trauma.
在颈椎下颈椎节段置入椎弓根螺钉是一项具有挑战性和复杂性的技术，但具有显著的生物力学优势。尽管存在潜在并发症，但颈椎椎弓根螺钉（CPS）的作用和应用正在不断增加。我们对1994年至2020年间关于在下颈椎节段应用椎弓根螺钉的重要文章进行了文献综述。此外，本研究还讨论了我们中心15年来与CPS相关的经验。下颈椎节段的经椎弓根器械置入需要深厚的解剖学知识和精细的手术技术。与其他颈椎固定技术相比，该技术提供了更好的生物力学稳定性。CPS的拔出强度是侧块螺钉的两倍。CPS技术有许多变体，从开放技术到微创技术，以及在此过程中使用生物模型和模板。临床上，CPS可用于不同的颈椎创伤情况，如骨折脱位、游离侧块以及与强直性脊柱炎相关的骨折。尽管由于椎动脉、脊髓和脊神经靠近颈椎椎弓根而存在神经血管损伤的可能性，但科学文献和我们中心的经验表明风险较低，并且该技术可以安全地进行。CPS置入是一种安全的手术，在颈椎创伤的治疗中具有巨大潜力。
