颈椎弓根钉手术在难复性下颈椎骨折脱位中的临床应用

Clinical Application of Internal Fixation for Fracture and Dislocation of Lower Cervical Spine with Pedicle screw

目的探讨颈椎弓根钉内固定术治疗难复性下颈椎骨折脱位的临床效果及操作技术。方法采用Oasys颈后路内固定系统运用个性化综合置钉法经颈椎弓根内固定治疗难复性下颈椎骨折脱位20例。每例均结合术前影像学测量结果及术中探查结果实施个性化置钉。结果术中未出现并发症,术后获得3～12个月随访,患者神经症状均有不同程度改善。影像学复查置钉准确,无断钉与螺钉松动现象。结论颈椎弓根钉内固定提供了三柱的稳定,是治疗难复性下颈椎骨折脱位安全有效的方法。掌握手术适应证、规范操作及置钉个性化是手术成功的关键。

Objective To probe the clinical effect and operative technique of the internal fixation for fracture and dislocation of lower cervical spine with pedicle screw. Methods Twenty patients with fracture and dislocation of lower cervical spine were treated with transpedicle screw fixation individually in Oasys system. Each operation result was measured by preoperative imaging and probing during the operation, and the screw was implanted individually. Results The complications were not observed in the surgeries. All of the patients were followed up for 3- 12 months postoperatively. All the patients nervous symptoms were improved after the surgeries. Imaging reexamination showed that the screws were in place without loosening and fracture. Conclusion Cervical transpedicle fixation provides tri - column stability and is a safe and effective treatment for fracture and dislocation of lower cervical spine. The key factors for a successful operation include selection of patients, standard skill of manipulation and individuality of screw placement.