颈椎后路侧块钢板螺钉置入治疗多节段颈椎病伴颈椎失稳

背景：侧块钢板螺钉内固定技术已广泛用于创伤及各种原因引起的颈椎不稳、滑脱和颈椎重建。目的：探讨后路椎板减压侧块固定辅助小关节撑开植骨融合治疗多节段颈椎病的效果。方法：作者以＂颈椎,侧块,内固定,植骨＂为检索词,在中国期刊全文数据库中,采用电子检索的方式进行文献检索。排除Meta分析及重复性研究,共检索到22篇文献,从颈椎侧块临床解剖、侧块螺钉固定技术,侧块螺钉固定疗效等方面进行探讨。结果与结论：颈椎侧块螺钉为后路短节段固定,最大限度地保留了颈椎的活动度,能实现对颈脊髓的充分减压,恢复椎间高度,维持颈椎生理曲度,稳定颈椎的失稳节段,并能预防颈椎后凸畸形以及神经根麻痹的发生及颈椎失稳的加重,是治疗多节段颈椎病伴颈椎失稳的有效方法。

Application of posterior cervical lateral mass plates and screws for the treatment of multilevel cervical myelopathy

BACKGROUND：Internal fixation of the lateral masses with plate and screw has been widely used to treat cervical instability,cervical spondylolisthesis,cervical reconstruction and other injuries caused by various reasons.OBJECTIVE：To discuss the therapeutic effect of posterior cervical mass fixation assisted with joint distraction in multilevel cervical myelopathy patients.METHODS：An online search of China Academic Journals Full-text Database was performed for the related articles with the keywor of ＂cervical vertebrae＂,＂lateral mass＂,＂internal fixation＂ and ＂bone graft＂.A total of 22 articles were retained after excluding meta-analysis and repetitive studies.These articles were analyzed from three following aspects mainly：the clinical anatomy of cervical lateral mass,the fixation technique of lateral mass screw and the efficacy of lateral mass screw fixation.RESULTS AND CONCLUSION：Lateral cervical mass screw fixation belongs to posterior cervical oligo-segmental fixation.It retains the maximum active degree of cervical vertebrate,adequately decompresses the cervical spinal cord,restores the intervertebral height,maintains the cervical physiological curvature and stabilizes the unstable cervical segments.In addition,it prevents the kyphosis deformity,nerve root palsy and the aggravation of cervical spinal instability.Therefore,lateral cervical mass screw fixation is an effective way to treat multilevel cervical myelopathy accompanied with cervical spinal instability.