AXIS颈椎侧块钢板治疗下颈椎不稳临床应用初步报告

The treatment of lower cervical spine instability with the AXIS lateral cervical mass plate: a preliminary report

目的观察AXIS颈椎侧块钢板治疗下颈椎不稳的近期疗效。方法于正常成人颈椎标本上观察侧块的解剖特点，测量侧块进针点、进针角度和深度。临床应用 AXIS颈椎侧块钢板治疗下颈椎不稳 22例。结果进针点宜选在术中可视侧块中点内下 1～ 2 mm处；进针角度分别为 :矢状面 36°～ 54° (平均 45° )；水平面 23°～ 35° (平均 29° )；进针深度为 10.8～ 17.5 mm(平均 14.5 mm)。无术中血管、神经损伤。 22例平均随访 10个月，未见钢板螺钉松脱、断裂等并发症。 19例获骨性融合，脊髓功能除 2例按 ASIA分级为 A级者术后无改善外，余均有不同程度恢复。结论 AXIS颈椎侧块钢板适合各种原因引起的需后路减压的下颈椎不稳患者的治疗。侧块固定有一定风险，但只要熟悉其解剖特点，正确选择进针点、角度和深度，规范操作，此技术是安全的，可获得良好的临床效果。

Objective To observe the preliminary results of lower cervical spine instability following the placement of AXIS lateral cervical mass plate. Methods The screw prick point, angle and depth were measured and defined on the lower cervical specimens. 22 cases of lower cervical spine instability suffering from a variety of cervical spinal disorders were treated with AXIS lateral cervical mass plate. Results The screw prick point was defined in the medial and lower 1－ 2 mm of the mass center. The arrow angle, horizontal angle and depth of internal fixation screw were 36－ 54 degree (45° ), 23－ 35 degree (29° ) and 10.8－ 17.5 mm (14.5 mm) respectively. 22 patients were followed-up for an average of 10 months. No complication of the injury to the arteries or nerve endings were found. There was no loosening of the plate and screw. 19 cases had bone union. The spinal cord function of all patients had improved to different degrees. Conclusion AXIS lateral cervical mass plate is suitable for the treatment of lower cervical spine instability.