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지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 277 - 281 (5page)
이용수
초록· 키워드
오류제보하기
Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.
목차
등록된 정보가 없습니다.
참고문헌 (20)
참고문헌 신청
Brooks AL / 1978 / Atlanto-axial arthrodesis by the wedge compression method / J Bone Joint Surg Am 60:279~284
Dickman CA / 1991 / The interspinous method of posterior atlantoaxial arthrodesis / J Neurosurg 74:190~198
Du S / 2017 / Application of unilateral C2 translaminar screw in the treatment for atlantoaxial iInstability as an alternative or salvage of pedicle screw fixation / World Neurosurg 97:86~92
Haher TR / 1999 / Occipital screw pullout strength. A biomechanical investigation of occipital morphology / Spine (Phila Pa 1976) 24:5~9
Harms J / 2001 / Posterior C1-C2 fusion with polyaxial screw and rod fixation / Spine (Phila Pa 1976) 26:2467~2471
Dickman CA / 1991 / The interspinous method of posterior atlantoaxial arthrodesis / J Neurosurg 74:190~198
Du S / 2017 / Application of unilateral C2 translaminar screw in the treatment for atlantoaxial iInstability as an alternative or salvage of pedicle screw fixation / World Neurosurg 97:86~92
Haher TR / 1999 / Occipital screw pullout strength. A biomechanical investigation of occipital morphology / Spine (Phila Pa 1976) 24:5~9
Harms J / 2001 / Posterior C1-C2 fusion with polyaxial screw and rod fixation / Spine (Phila Pa 1976) 26:2467~2471
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