このエントリーをはてなブックマークに追加
ID 32889
JaLCDOI
FullText URL
Author
Nakanishi, Kazuo
Sugimoto, Yoshihisa
Ozaki, Toshifumi Kakenhi
Abstract

We performed fixation using laminar screws in 2 patients in whom lateral mass screws, pedicle screws or transarticular screws could not be inserted. One was a 56-year-old woman who had anterior atlantoaxial subluxation (AAS). When a guide wire was inserted using an imaging guide, the hole bled massively. We thought the re-insertion of a guide wire or screw would thus increase the risk of vascular injury, so we used laminar screws. The other case was an 18-year-old man who had a hangman fracture. Preoperative magnetic resonance angiography showed occlusion of the left vertebral artery. A laminar screw was inserted into the patent side (i.e., the right side of C2). Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion, because the cervical pedicle is small and is adjacent laterally to the vertebral artery, medially to the spinal cord, and vertically to the nerve roots. Lateral mass screws are also reported to involve a risk of neurovascular injuries. The laminar screw method was thus thought to be useful, since arterial injuries could thus be avoided and it could also be used as a salvage modality for the previous misinsertion.

Keywords
laminar screw
neurovascular complications
lateral mass screw
pedicle screw
transarticular
Amo Type
Case Report
Published Date
2007-04
Publication Title
Acta Medica Okayama
Volume
volume61
Issue
issue2
Publisher
Okayama University Medical School
Start Page
115
End Page
119
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
File Version
publisher
Refereed
True
PubMed ID
Web of Sience KeyUT