Posterior cervical spine arthrodesis incorporating C2 laminar screw fixation in the treatment of cervical spine injury

Objective: To investigate the clinical application and efficacy of an internal fixation technique incorporating C₂ laminar screws for upper cervical spine injury. Methods: Using a posterior cervical approach, incorporating C₂ laminar screw fixation and bone grafting were performed on 20 patients with cervical spine injury. There were 12 male and 8 female patients, with a mean age of 45.6 years (range, 32–71 years). All patients were evaluated by X‐ray, computed tomography (CT) and magnetic resonance imaging (MRI). Results: The patients were followed up for 11–35 months (mean, 15 months), and bony union was achieved in all patients. There were no spinal cord or vertebral artery injuries during surgery, and only two instances of vein clump injury, in both of which the bleeding was controlled successfully. Postoperative CT scans showed that all the C₂ laminar screws had been placed properly, and were not encroaching on the spinal canal. No spinal instability, evidence of hardware failure or screw loosening was found during the follow‐up period in any patient. Conclusion: Crossing C₂ laminar screw internal fixation technique is simple, and is not limited by the position of the vertebral artery in the body of C₂. The laminar screw method avoids arterial injuries and also can be used as a salvage method after previous misinsertion. As all relevant structures are directly visualized during C₂ laminar screw placement, this kind of technique may be applicable to a large number of patients.