Khattak Sabir Khan, Hussain Sajid, Khan Latif, Haider Ibtisam, Aziz Amer
Sabir Khan Khattak, Department of Orthopedic and Spine Surgery, Ghurki Trust and Teaching Hospital, Lahore, Pakistan.
Sajid Hussain, Department of Orthopedic and Spine Surgery, Ghurki Trust and Teaching Hospital, Lahore, Pakistan.
Pak J Med Sci. 2025 Apr;41(4):1019-1022. doi: 10.12669/pjms.41.4.11894.
This study aimed to analyze the functional and neurological outcome of patients diagnosed with subaxial cervical spine bilateral facet dislocation managed by standard posterior midline approach and lateral mass screw fixation by Margerl technique.
We retrospectively evaluated 22 patients with traumatic cervical spine injuries who presented at the Orthopaedics and Spine Centre Ghurki Trust Teaching Hospital, Lahore from March 2020 to October 2023. Patients included in this study who has subaxial cervical spine bilateral facet dislocation managed by standard posterior midline approach and lateral mass screw fixation by Magerl technique. Functional outcomes was assessed by neck disability index and ASIA impairment scale at last follow up. Preoperative and post operative neurological status was evaluated with ASIA impairment scale. All the data were analyzed using SPSS version 23.
Total 22 patients participated in the study of which 72.73% were male and 27.27% female. Mean age was 39±17.02(13-70) years. Regarding level of dislocation, most common level was C5-6 which was involved in 12 patients, followed by C3-4 and C4-5 which was involved in five patients each. Pre-operatively 50% of the patients had intact neurology (ASIA E), followed by ASIA D which made up of the 27.27% patients, ASIA C 9.09%, ASIA B patients (4.55%), ASIA A 9.09% illustrating the severity of the neurological dysfunction. Postoperatively no neurological recovery was observed in ASIA A or ASIA B patients, while all ASIA C and D patients showed complete recovery. Mean Neck Disability Index (NDI) was 21±19.44.
After a good reduction, lateral mass screws fixation are a safe and reliable approach for cervical fixation that not only stabilizes the cervical spine but also leads to a patient's excellent functional recovery.
本研究旨在分析采用标准后正中入路及Margerl技术行侧块螺钉固定治疗下颈椎双侧关节突脱位患者的功能及神经学转归。
我们回顾性评估了2020年3月至2023年10月在拉合尔古尔基信托教学医院骨科与脊柱中心就诊的22例创伤性颈椎损伤患者。本研究纳入的患者采用标准后正中入路及Magerl技术行侧块螺钉固定治疗下颈椎双侧关节突脱位。末次随访时采用颈部残疾指数和美国脊髓损伤协会（ASIA）损伤分级评估功能转归。术前及术后采用ASIA损伤分级评估神经学状态。所有数据均使用SPSS 23版进行分析。
共有22例患者参与本研究，其中男性占72.73%，女性占27.27%。平均年龄为39±17.02（13 - 70）岁。关于脱位节段，最常见的节段是C5 - 6，有12例患者受累，其次是C3 - 4和C4 - 5，各有5例患者受累。术前，50%的患者神经功能完整（ASIA E级），其次是ASIA D级，占27.27%的患者，ASIA C级占9.09%，ASIA B级患者占4.55%，ASIA A级占9.09%，说明神经功能障碍的严重程度。术后，ASIA A级或ASIA B级患者未观察到神经功能恢复，而所有ASIA C级和D级患者均显示完全恢复。平均颈部残疾指数（NDI）为21±19.44。
在良好复位后，侧块螺钉固定是一种安全可靠的颈椎固定方法，不仅能稳定颈椎，还能使患者获得良好的功能恢复。
