经关节螺钉固定术在下颈椎骨折脱位中的应用

Transarticular Screws for Treatment of Fracture and Dislocation of Lower Cervical Spine

目的 探讨及评价经关节突螺钉技术治疗下颈椎脱位的应用效果。方法 使用经关节突螺钉技术治疗下颈椎骨折脱位17例，其中单节段固定12例，双节段5例。改良Klekamp经关节螺钉固定技术，以上位节段侧块背面中心点偏内侧1mm、偏下方1mm为入钉点，外倾20～25°，下倾35～40°行四层皮质固定。结果所有患者均获得随访，患者颈椎基本达到完全复位，无椎动脉及颈髓损伤等并发症，均达到了骨性愈合。结论 下颈椎经关节突螺钉置入简单，安全性高，生物力学固定融合性能好，适应范围广泛，是传统后路固定融合方法的创新与补充。

Objective To evaluate the effect of transarticular screws in treatment of fracture and dislocation of lower cervical spine. Methods From March 2006 to June 2007, 17 patients with cervical fracture and dislocation were treated with posterior transarticular screws. The single segment was fixed in 12 patients and 2 segments were fixed in 5. The technique of modified Klekamp transarticular screws was used. The entry point of screws insertion was located 1 mm inside and 1 mm under to the midpoint of lateral mass. With insertion angle of 20-25°protrudently and 35-40° downwards, 4 layer cortex were fixed. Results No serious complications occurred. All the fracture got fusion. Conclusion The technique of transarticular screws for treatment of fracture and dislocation of the lower cervical spine is useful and safe, and it can be widely used.