The application of C2 transpedicular screw, C1 laminar hook fixation and bone graft in the atlantoaxial instability

Sukru Oral
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Abstract

Aim/Background Traumatic atlantoaxial instability usually results from a motor vehicle accident, falls and motorcycle accidents. Atlantoaxial instability can lead to spinal cord compression and neck pain, but, spasticity and radicular symptoms as well. The purpose of surgery is to remove the compression and stabilize the joint permanently. To date, several surgical techniques have been described to remedy C1-C2 instability. In this study, the clinical and radiological outcomes of patients who operated with the C1 (Atlas bone) laminar hooks fixation and bilateral C2 (Axis bone) trans-pedicular screw technique were shown. Also, the advantages and disadvantages of this technique are discussed. Methods From March 2010 to December 2017, 12 patients who have atlantoaxial instability were surgically treated by modified fixation technique which consists C1 laminar hooks fixation and bilateral C2 transpedicular screw. Results Twelve patients were operated with this procedure from March 2010 to December 2017. All the patients were checked with flexion-extension x-rays at the end of the twelfth week. The posterior bony fusion formation was observed on imaging in all patients. Conclusion C2 bilateral pedicle screw combined with C1 laminar hook system is a good method for atlantoaxial instability in the conditions which is not convenient for insertion of C1 lateral mass and C2 trans-articular screw. However, this method may not be available in some cases such as traumatic, infection, neoplastic or degenerative pathologies in which the posterior arch of the atlas is damaged.
C2经椎弓根螺钉、C1椎板钩固定及植骨在寰枢椎不稳中的应用
目的/背景外伤性寰枢椎不稳定通常由机动车事故、跌倒和摩托车事故引起。寰枢椎不稳定可导致脊髓压迫和颈部疼痛,但也可导致痉挛和神经根症状。手术的目的是消除压迫,使关节永久稳定。迄今为止,已有几种手术技术被描述用于治疗C1-C2不稳定。本研究显示了采用C1(寰椎骨)椎板钩固定和双侧C2(轴椎骨)经椎弓根螺钉技术的患者的临床和影像学结果。并对该技术的优缺点进行了讨论。方法2010年3月至2017年12月对12例寰枢椎不稳患者行改良固定技术,采用C1椎板钩固定+双侧C2经椎弓根螺钉固定。结果2010年3月至2017年12月共12例患者采用该方法手术。所有患者在第12周结束时进行了屈伸x线检查。所有患者在影像学上均观察到后路骨融合形成。结论C2双侧椎弓根螺钉联合C1椎弓根钩系统是治疗寰枢椎不稳不方便置入C1侧块和C2经关节螺钉的良好方法。然而,这种方法可能不适用于某些病例,如创伤、感染、肿瘤或退行性病变,其中寰椎后弓受损。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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