经后路联合使用侧块钢板螺钉和椎弓根钉内固定治疗下颈椎损伤

目的探讨经颈后正中人路联合使用侧块钢板螺钉和T．椎弓根钉内固定手术在治疗下颈椎C6～C7损伤的应用。方法应用此项技术治疗下颈椎损伤8例。其中,C6-7 6例,C7 2例。术前ASIA分级3例为C级,5例为D级。手术采用颈椎侧块钢板螺钉和T1椎弓根钉联合内固定。结果本组8例患者平均随访15个月(5～37个月),术后脊髓损伤无加重,脊髓功能均有改善,无血管、神经并发损伤。结论经颈后正中人路联合颈椎侧块钢板螺钉和椎弓根钉内固定是治疗下颈椎损伤的一种好方法。

The use of lateral mass screws and pedicle screws for the treatment of injury of lower cervical spine

Objective To discuss the effect of the use of the cervical lateral mass plates screws and T_1 pedicle screws for the treatment of C_6 to C_7 injury through posterior approach. Methods There were 8 patients in the study group; Each of them had been injured with low cervical spine C_6 or C_7. There were 6 cases with C_6-C_7 injury and 2 cases with C_7 injury. According to ASIA classification, 3 cases were in grade C and 5 cases in D. The lateral mass screws were placed on the lateral masses using Margel technique. Lamina or facet bone allografting were used to achieve a long-term stability. Results All 8 patients were followed up from 5 to 37 months (mean 15months). No operative death occurred. There were no cord or vertebral artery injury, cerebrospinal fluid leak, nerve roots injury, screw malposition or back out, loose of alignment or implant failure. Clinical symptom and ASIA classification were improved in all patients. Postoperative MRI scanning confirmed satisfactory screw placement in all cases. Conclusion This technique is safe and benefit to patients with low cervical spine C_6 or C_7 injury.