组合枢椎椎板螺钉及经枢椎椎板关节突螺钉固定技术的临床应用

目的探讨组合枢椎椎板螺钉及经枢椎椎板关节突螺钉(TLFS)固定技术治疗颈椎损伤的可行性和应用价值。方法自2005年10月～2008年10月,采用枢椎椎板螺钉及经枢椎TLFS固定技术治疗颈椎损伤36例。结果本组获随访13~32个月,平均18个月。30例行自体髂骨植骨,6例行异体骨植骨,获得了良好的骨性愈合。术后CT示枢椎椎板螺钉及经枢椎TLFS位置良好,未侵犯椎管和脊髓。结论枢椎椎板螺钉及经枢椎TLFS固定技术不受C2横突孔中椎动脉的位置和C2椎弓根大小限制,避免了螺钉置入过程中损伤椎动脉的风险,所以该方法可作为传统枢椎后路螺钉固定技术的补充。

Clinical application of combined with axis laminar screw and axis translaminar facet screw fixation technique

Objective To explore the feasibility and application value of combined axis laminar screw and axis translaminar facet joint screw fixation technique in treatment of cervical vertebral injury.Methods From October 2005 to October 2008,36 patients with cervical vertebral injury were treated with axis laminar screw and axis translaminar facet joint screw fixation technique.Results All cases were followed up for 13 to 32 months(18 months on average).Thirty two cases achieved bone fusion,among which,autogenous iliac graft were done in 30 cases and variant bone graft were done in 6 cases.The postoperative CT scan showed all the axis laminar screws and axis translaminar facet joint screws had been placed properly,and did not invade the spinal canal and the spinal cord.Conclusion Axis laminar screw and axis translaminar facet joint screw fixation technique is free from limitation of the vertebral artery in the C2 foramen and the C2 pedicle size,and can prevent the risk of vertebral artery injury during screw insertion.So axis laminar screw and axis translaminar facet joint screw insertion may facilitate it as a supplementary method for conventional posterior axis screw fixation.