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Clinical application of C2 laminar screw technique
Weihu Ma1, Leling Feng, Rongming Xu
1Department of Orthopedic Surgery, The Sixth Hospital of Ningbo, 1059 Zhongshan East Road, Ningbo, 315040 Zhejiang, People's Republic of China. m87370016@126.com
Summary
C2 laminar screws provide a safe and effective alternative to pedicle screws for upper cervical instability. This technique reliably restores stability without neurological complications.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- C2 laminar screw fixation is an emerging alternative to C2 pedicle screw fixation for upper cervical instability.
- The clinical outcomes and safety profile of C2 laminar screw fixation require further investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of C2 laminar screw fixation in patients with upper cervical instability.
- To compare C2 laminar screw fixation with traditional C2 pedicle screw fixation.
Main Methods:
- Retrospective review of 35 cases with upper cervical instability treated with C2 laminar screw fixation using the Vertex cervical internal fixation system.
- Analysis of intraoperative complications, neurological status, vascular injury, and hardware-related issues via clinical assessment and computed tomographic scans.
Main Results:
- All 68 C2 laminar screws were successfully placed, with no intraoperative complications, neurological worsening, or vascular injury.
- Ten patients (28.6%) had partial dorsal laminar breaches on CT scans, none causing neurological symptoms.
- No ventral laminar cortex breaches or hardware failures were observed during the follow-up period.
Conclusions:
- C2 laminar screw fixation is a straightforward and reliable technique for restoring upper cervical stability.
- It serves as a viable alternative to C2 pedicle screw fixation, particularly in cases with vertebral artery anomalies or C2 pedicle deformities.
