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 C(2) laminar screws for upper cervical spine injury.


METHODS
Using a posterior cervical approach, incorporating C(2) 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 C(2) 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.


CONCLUSIONS
Crossing C(2) laminar screw internal fixation technique is simple, and is not limited by the position of the vertebral artery in the body of C(2). 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 C(2) laminar screw placement, this kind of technique may be applicable to a large number of patients.
Department of Spine Surgery, Ningbo Sixth Hospital, Zhejiang Province, China. huyong610@163.com
Yong
Y
Hu
Yong-jie
YJ
Gu
Peng-han
PH
Ye
Wei-hu
WH
Ma
Rong-ming
RM
Xu
Xian-feng
XF
He
D000328:Adult; D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods