Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 an...
Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.
Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
제안 방법
Preoperative magnetic resonance image showing an expansile bony lesion involving the body and posterior elements of the C6 vertebra with marked compression of the spinal cord (A). He underwent radical tumor resection including the body of C6 and anterior and posterior reconstruction at the level of C3-T2 using a titanium mesh and plate and the polyaxial screw-rod system (B), (C).
The authors report the clinical experiences of cervical stabilization with a polyaxial screwrod system and investigate the safety, surgical efficacy, and advantages of a polyaxial screwrod system for posterior occipitocervicothoracic arthrodesis that addresses some of the limitations associated with lateral mass plating.
The patients were followed-up and were evaluated based on their clinical status and radiographs at 1, 3, 6 months, and 1 year after surgery. Satisfactory bony fusions and reductions were achieved and confirmed by postoperative flexion-extension lateral radiographs and CT scans in all patients, with the exception of 2 cases due to a lack of follow up data.
대상 데이터
4. A 40-year-old man presented with quadriparesis. He had cerebral palsy and a history of diffuse idiopathic skeletal hyperostosis.
2. A 66-year-old woman presented with quadriparesis. She had a history of rheumatoid arthritis.
Thirty-two patients underwent posterior cervical arthrodesis. A total of 189 screws were implanted in all patients. The mean number of levels fused was 3.
2 months. Laminectomy was performed in 11 patients, and concomitant anterior reconstructive surgery was performed in 6 patients.
This study was based on the charts and radiological records of 32 patients who were treated at our institution. The patients were operated from October 2004 to February 2006, and all patients were treated by posterior cervical fixation using a polyaxial screw-rod system. There were 21 men and 11 women (age range, 19 to 74 years; mean, 47.
This study was based on the charts and radiological records of 32 patients who were treated at our institution. The patients were operated from October 2004 to February 2006, and all patients were treated by posterior cervical fixation using a polyaxial screw-rod system.
참고문헌 (23)
An HS, Coppes MA : Posterior cervical fixation for fracture and degenerative disc disease. Clin Ortho 335 : 101-111, 1997
Benzel EC, Kesterson L : Posterior cervical interspinous compression wiring and fusion for mid to low cervical spine injuries. J Neurosurg 70 : 893-899, 1989
Branch CL Jr, Kelly DL Jr, Davis CH Jr, McWhorter JM : Fixation of fractures of the lower cervical spine using methylmethacrylate and wire : Technique and results in 99 patients. Neurosurgery 25 : 503- 512, 1989
Crockard A : Evaluation of spinal laminar fixation by a new, flexible stainless steel cable (Sof'wire) : early results. Neurosurgery 35 : 892- 898, 1994
Deen HG, Birch BD, Wharen RE, Reimer R : Lateral mass screwrod fixation of the cervical spine : A prospective clinical series with 1- year follow-up. Spine J 3 : 489-495, 2003
Ebraheim NA, Klausner T, Xu R, Yeasting RA : Safe lateral mass screw lengths in the Roy-Camille and Margerl techniques : an anatomic study. Spine 23 : 1739-1742, 1998
Geisler FH, Mirvis SE, Zrebeet H, Joslyn JN : Titanium wire internal fixation for stabilization of injury of the cervical spine : Clinical results and postoperative magnetic resonance imaging of the spinal cord. Neurosurgery 25 : 356-362, 1989
Graham AW, Swank ML, Kinard RE, Lowery GL, Dials BE : Posterior cervical arthrodesis and stabilization with a lateral mass plate. Clinical and computed tomographic evaluation of lateral mass screw placement and associated complications. Spine 21 : 323-329, 1996
Horgan MA, Kellogg Jx, Chesnut RM : Posterior cervical arthrodesis and stabilization : an early report using a novel lateral mass screw and rod technique. Neurosurgery 44 : 1267-1272, 1999
Lee DC, Yoon SH, Park HC, Park JO, Hyun DK, Park HS : Clinical and computed tomography evaluation of plate and screw on the cervical lateral mass : a modified Magerl's technique. J Korean Neurosurg Soc 39 : 251-255, 2006
McCullen GM, Garfin SR : Spine update : cervical spine internal fixation using screw and screw-plate constructs. Spine 22 : 274-282, 1997
Mirvis SE, Geisler F, Joslyn JN, Zrebeet H : Use of titanium wire in cervical spine fixation as a means to reduce MR artifacts. AJNR Am J Neuroradiol 9 : 1229-1231, 1988
Muffoletto AJ, Hadjipavlou AG, Jensen RE, Nauta HJ, Necessary JT, Norcross-Nechay K : Techniques and pitfalls of cervical lateral mass plate fixation. Am J Orthop 29 : 897-903, 2000
Mummaneni PV, Haid RW, Traynelis VC, Sasso RC, Subach BR, Fior AJ, et al : Posterior cervical fixation using a new polyaxial screw and rod system : technique and surgical results. Neurosurg Focus 12 : 1-5, 2002
Wellman BJ, Follett KA, Traynelis VC : Complications of posterior articular mass plate fixation of the subaxial cervical spine in 43 consecutive patients. Spine 23 : 193-200, 1998
Xu R, Haman SP, Ebraheim NA, Yeasting RA : The anatomic relation of lateral mass screws to the spinal nerves : a comparison of the Magerl, Anderson, and An techniques. Spine 24 : 2057-2061, 1999
Yoshimoto H, Sato S, Hyakumachi T, Yanagibashi Y, Masuda T : Spinal reconstruction using a cervical pedicle screw system. Clin Orthop Relat Res 431 : 111-119, 2005
※ AI-Helper는 부적절한 답변을 할 수 있습니다.