このエントリーをはてなブックマークに追加
ID 32889
JaLCDOI
フルテキストURL
著者
Nakanishi, Kazuo Okayama University
Sugimoto, Yoshihisa Okayama University
Ozaki, Toshifumi Okayama University Kaken ID publons researchmap
抄録

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.

キーワード
laminar screw
neurovascular complications
lateral mass screw
pedicle screw
transarticular
Amo Type
Case Report
発行日
2007-04
出版物タイトル
Acta Medica Okayama
61巻
2号
出版者
Okayama University Medical School
開始ページ
115
終了ページ
119
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Science KeyUT