Hertlein H, Mittlmeier T, Schürmann M, Lob G
Unfallchirurgie, Universität München, Germany.
Eur Spine J. 1994;3(1):52-5. doi: 10.1007/BF02428317.
A new technique for the stabilization of metastatic cervical instability of the axis and/or neighboring vertebrae at lower levels is described. By a combination of the transarticular screw fixation C1/2 (Magerl) with the hook plate technique (Magerl) (or facultatively with a 1/3 tubular or 3.5 mm dynamic compression plate) from a posterior approach, the risks and stresses on the patient of a transoral or a combined extended technique are avoided, creating a proven biomechanically stable situation. The new technique is particularly helpful in those patients with a rapid progression of their malignant disease in whom local tumor growth is not expected to compress the spinal cord, and palliative stabilization of the unstable upper cervical spine can avoid neurological deficits or alleviate pain syndromes at a minimized morbidity due to surgery. The new technique has been successfully applied in a limited clinical series of four patients with metastasis of the cervical spine, resulting in substantial improvement of the general condition and cervical pain syndrome and stability of the assemblage during the observation period (4-9 months).
本文描述了一种稳定枢椎和/或较低节段相邻椎体转移性颈椎不稳的新技术。通过后路将C1/2经关节螺钉固定（马格勒法）与钩板技术（马格勒法）（或视情况使用1/3管状或3.5mm动力加压钢板）相结合，避免了经口或联合扩大技术给患者带来的风险和压力，创造了一种经证实的生物力学稳定状态。这项新技术对那些恶性疾病进展迅速且预计局部肿瘤生长不会压迫脊髓的患者特别有帮助，对上颈椎不稳进行姑息性稳定可以避免神经功能缺损，或在手术发病率降至最低的情况下缓解疼痛综合征。这项新技术已成功应用于4例颈椎转移患者的有限临床系列中，在观察期（4 - 9个月）内，患者的一般状况、颈椎疼痛综合征和颈椎稳定性均有显著改善。
