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Qiang Jian^1,2, Weiwei Da^1,3, Jason DePhillips⁴

¹Department of Neurosurgery, Columbia University, New York, NY.

|May 5, 2025

概括

新的C2固定技术,中间的进出入和亚面螺丝,为C1-2稳定提供了可行的替代方案. 这些方法提供了强大的固定,特别是在具有挑战性的解剖学中,扩大了手术选择.

科学领域:

脊柱生物力学脊柱生物力学
整形外科手术整形外科手术
神经外科神经外科

背景情况:

由于血管和脚的变化,C2脊椎解剖学对螺丝固定提出了挑战.
作为替代方案,提出了新的中介内外内和亚面螺丝轨迹.
中间的进出入轨道允许三点皮质固定,而次面轨道绕过脊椎动脉 (VA).

研究的目的:

为了比较五个C2螺杆轨迹的生物力学稳定性和固定强度.
评估用于C1-2稳定的脚,帕斯,跨层,中间进出入和亚面螺丝方法.

主要方法:

一个尸体生物力学研究涉及12个标本.
将多轴螺丝插入C1侧面质量和C2脊椎.
测量C1-2运动范围 (ROM) 在曲/延伸,侧向曲和轴向旋转的完整和螺杆结构.
对C2螺丝进行拉出测试.

主要成果:

与所有运动方向的完整标本相比,螺杆结构显著减少了86-97%的ROM.
在测试的C2螺杆轨迹之间,没有发现ROM的显著差异.
中间的进出进螺丝显示出比脚螺丝的拉出强度大10%,次面螺丝显示出比帕斯螺丝的拉出强度大83%.

结论:

中间进出入和亚面螺丝轨迹是C1-2稳定的有效替代方案.
这些技术在具有解剖学约束的病例中尤其有用,例如高的脊椎动脉或狭窄的C2脚.
新的C2固定方法扩大了用于安全C1-2固定的手术选择.

关键词:

C2 脚 (pedicle) 是一个脚 C2 螺丝螺丝螺丝 C2轨迹的轨迹是C2的轨迹.亚特兰大的轴向稳定.脊椎动脉损伤脊椎动脉损伤

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