[Pedicle exposure technique for atlas screw fixation:a radiological research].

Autor:	Ma HN, Liu CY, Jiang LH, Yi P, Yang F, Tang XS, Tan MS; Department of Spinal Surgery, China Japan Friendship Hospital, Beijing 100029, China; zranms@sina.com.
Jazyk:	čínština
Zdroj:	Zhongguo gu shang = China journal of orthopaedics and traumatology [Zhongguo Gu Shang] 2016 Oct 25; Vol. 29 (10), pp. 903-909.
DOI:	10.3969/j.issn.1003-0034.2016.10.007
Abstrakt:	Objective: To investigate the meaning of pedicle exposure technique for screw fixation on atlas with the vertebral groove height less than 4 mm by using reconstructive computed tomography. Methods: From April 2015 to June 2015, 84 pedicles of 51 patients with groove heights less than 4 mm were studied by digital reconstruction respectively. Parameters of atlas pedicle screw fixation were measured. Results: Among the 51 cases, the vertebral groove height was (3.28±0.51) mm. Lateral mass heights, lateral mass widths and the transition area heights between lateral mass and posterior arch were fit for 3.5 mm screw implanting. Ideal pedicle screw trajectory lengths from 0° to 15° (0°, 5°, 10°, 15°) were (27.36±1.81), (27.01±1.68), (27.07±1.75), (27.48±1.72) mm, exposed trajectory lengths from 0° to 15°(0°, 5°, 10°, 15°) were(23.44±1.79), (23.87±1.84), (24.58±1.89), (25.56±2.01) mm, trajectory length of lateral mass was (20.78±2.05) mm. The mean CT values on 5 sections through pedicle trajectory and lateral mass trajectory were (701.89±141.48) HU and (599.11±137.33) HU, respectively. There were no significant differences between ideal pedicle trajectory lengths from 0° to 15°( P >0.05). Exposed trajectory lengths was significantly increased accompanying with medial angles increasing ( P <0.05), and was longer than trajectory lengths of lateral mass ( P <0.05). CT value of pedicle screws was higher than CT value of lateral mass screws significantly ( P <0.01). Conclusions: Screws can be implanted in atlas with vertebral groove height less than 4 mm by using pedicle exposure technique. Few trajectory lengths will be sacrificed with favorable pull out strength due to adequate bone mass purchased. Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.
Databáze:	MEDLINE
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