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学科主题: 临床医学
题名:
Radiographic Evaluation of the Technique for C1 Lateral Mass and C2 Pedicle Screw Fixation in Three Hundred Nineteen Cases
作者: Wang, Shenglin1; Wang, Chao1; Wood, Kirkham B.2,3; Yan, Ming1; Zhou, Haitao1
关键词: atlantoaxial fixation ; C1 lateral mass screw ; C2 pedicle screw ; vertebral artery injury ; computed tomography
刊名: SPINE
发表日期: 2011
DOI: 10.1097/BRS.0b013e3181c97dc7
卷: 36, 期:1, 页:3-8
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Orthopedics
研究领域[WOS]: Neurosciences & Neurology ; Orthopedics
关键词[WOS]: POSTERIOR ATLANTOAXIAL FIXATION ; VERTEBRAL ARTERY ; POLYAXIAL SCREW ; C1-C2 COMPLEX ; PLATE ; PLACEMENT ; STABILIZATION ; ANGIOGRAPHY ; FUSION ; SAFETY
英文摘要:

Study Design. Retrospective radiographic study of the technique for C1 lateral mass screw (C1LMS) and C2 pedicle screw (C2PS) fixation.

Objective. To evaluate (1) the accuracy of the C1LMS and C2PS placement; (2) the fusion rate between C1 and C2; (3) the risk for vertebral artery (VA) injury.

Summary of Background Data. C1LMS and C2PS fixation is widely used when treating atlantoaxial instability. Several authors have reported their experience focusing on the technical outcomes, with many reporting fusion rates near 100%. However, most of them are relatively small series, and many have applied only plain postoperative radiographs instead of computed tomography (CT). Thus, we feel that the accuracy of C1LMS and C2PS placement has not been fully analyzed, as well as the anatomic relationship between the VA and the screws.

Methods. Between December 2000 and September 2008, the fusion status and accuracy of the screws were evaluated on the postoperative reconstructive CT of 319 patients with atlantoaxial instability. Cases with malpositioned screws underwent CT angiography or magnetic resonance angiography after surgery, to evaluate potential VA injury.

Results. C1LMS of 95.5% and C2PS of 92.8% were found to be in a "good" position. After 2007, six cases had malpositioned screws, which were all in the "out" or "down" area of the C2 pedicle. Five cases underwent CT angiography and 1 had magnetic resonance angiography to evaluate potential VA injury. No occlusion, associated aneurysm or fistula of the VA was found. All cases (100%) achieved solid fusion between C1 and C2.

Conclusion. C1LMS of 95.5% and C2PS of 92.8% were confirmed to be in good position. None of the screws including the malpositioned caused VA injury, clinically or radiographically. The technique for C1LMS and C2PS fixation appears to be safe and effective.

语种: 英语
WOS记录号: WOS:000285778700013
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62818
Appears in Collections:北京大学第三临床医学院_骨科_期刊论文

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作者单位: 1.Harvard Univ, Sch Med, Boston, MA USA
2.Peking Univ, Hosp 3, Dept Orthopaed, Beijing 100191, Peoples R China
3.Massachusetts Gen Hosp, Dept Orthopaed Surg, Boston, MA 02114 USA

Recommended Citation:
Wang, Shenglin,Wang, Chao,Wood, Kirkham B.,et al. Radiographic Evaluation of the Technique for C1 Lateral Mass and C2 Pedicle Screw Fixation in Three Hundred Nineteen Cases[J]. SPINE,2011,36(1):3-8.
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