...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Spine >Posterior C1-C2 fusion with polyaxial screw and rod fixation.
【24h】

Posterior C1-C2 fusion with polyaxial screw and rod fixation.

机译：后路C1-C2融合，多轴螺钉和棒固定。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

STUDY DESIGN: A novel technique of atlantoaxial stabilization using individual fixation of the C1 lateral mass and the C2 pedicle with minipolyaxial screws and rods is described. In addition, the initial results of this technique on 37 patients are described. OBJECTIVES: To describe the technique and the initial clinical and radiographic results for posterior C1-C2 fixation with a new implant system. SUMMARY OF BACKGROUND DATA: Stabilization of the atlantoaxial complex is a challenging procedure because of the unique anatomy of this region. Fixation by transarticular screws combined with posterior wiring and structural bone grafting leads to excellent fusion rates. The technique is technically demanding and has a potential risk of injury to the vertebral artery. In addition, this procedure cannot be used in the presence of fixed subluxation of C1 on C2 and in the case of an aberrant path of the vertebral artery. To address these limitations, a new technique of C1-C2 fixation has been developed: bilateral insertion of polyaxial-head screws in the lateral mass of C1 and through the pars interarticularis into the pedicle of C2, followed by a fluoroscopically controlled reduction maneuver and rod fixation. METHODS: After posterior exposure of the C1-C2 complex, the 3.5-mm polyaxial screws are inserted in the lateral masses of C1. Two polyaxial screws are then inserted into the pars interarticularis of C2. Drilling is guided by anatomic landmarks and fluoroscopy. If necessary, reduction of C1 onto C2 can be accomplished by manipulation of the implants, followed by fixation to the 3-mm rod. For definitive fusion, cancellous bone can be added. No structural bone graft or wiring is required. In selected cases, e.g., C1-C2 subluxation or fractures in young patients in whom only temporary fixation is necessary, the instrumentation can be removed after an appropriate time. Because the joint surfaces stay intact, the patient can regain motion in the C1-C2 joints. RESULTS: Thirty-seven patients underwent this procedure. No neural or vascular damage related to this technique has been observed. The early clinical and radiologic follow-up data indicate solid fusion in all patients. CONCLUSION: Fixation of the atlantoaxial complex using polyaxial-head screws and rods seems to be a reliable technique and should be considered an efficient alternative to the previously reported techniques.
机译：研究设计：描述了一种寰枢椎稳定技术，该技术通过使用微型多轴螺钉和棒分别固定C1侧块和C2椎弓根来进行。此外，还介绍了该技术对37例患者的初步结果。目的：描述使用新的植入系统进行后C1-C2固定的技术以及初步的临床和放射学结果。背景数据摘要：由于该区域的独特解剖结构，因此稳定寰枢椎复合体是一项具有挑战性的手术。经关节螺钉固定，结合后路布线和结构性植骨，可实现出色的融合率。该技术在技术上是苛刻的，并且具有伤害椎动脉的潜在风险。此外，在C1在C2上固定半脱位的情况下，以及在椎动脉路径异常的情况下，不能使用此程序。为了解决这些局限性，已开发出一种C1-C2固定的新技术：将多轴头螺钉双向插入C1的侧块，并通过关节间隙插入C2的椎弓根，然后进行荧光检查控制的复位操作和棒固定。方法：向后暴露C1-C2复合体后，将3.5毫米多轴螺钉插入C1的侧块。然后将两个多轴螺钉插入C2的关节间。钻孔以解剖标志物和荧光透视法为指导。如有必要，可通过操纵植入物，然后将其固定到3毫米杆上，将C1还原为C2。为了确定性融合，可以添加松质骨。无需结构性骨移植或布线。在某些情况下，例如C1-C2半脱位或年轻患者的骨折，这些患者仅需要临时固定，可以在适当的时间后将器械取出。由于关节表面保持完整，因此患者可以恢复C1-C2关节的运动。结果：37例患者接受了该手术。尚未观察到与此技术有关的神经或血管损伤。早期的临床和放射学随访数据表明，所有患者均发生固体融合。结论：使用多轴头螺钉和棒固定寰枢椎复合物似乎是一种可靠的技术，应被认为是先前报道技术的一种有效替代方法。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号