Management of fracture-dislocation of the lower cervical spine with the cervical pedicle screw system

INTRODUCTION Usually, cervical pedicle screw fixation has been considered too risky for neurovascular structures. The purpose of this study was to investigate the method and efficacy of the cervical pedicle screw system for fracture-dislocation of the cervical spine because of its rigid fixation. PATIENTS AND METHODS A prospective study was conducted involving 48 patients with cervical spine fracture-dislocation who underwent cervical pedicle screw fixation surgery between January 2003 and January 2007. All patients had various degrees of cord injury, and they were classified according to the American Spinal Cord Injury Association (ASIA) Impairment Scale: 18 cases were grade A, 15 grade B, 10 grade C, and 5 grade D. RESULTS Six months after the operation, all patients had achieved solid bony fusion and stable fixation of the related segments. Thirty patients with incomplete spinal cord injury improved their ASIA Impairment Scale classification by 1 to 2 grades after the operation. Eighteen patients with complete spinal cord injury had no improvement in neural function. However, nerve root symptoms such as pain and numbness were alleviated to some extent. CONCLUSIONS The cervical pedicle screw system is an effective and reliable method for the restoration of cervical stability. Sufficient pre-operative imaging studies of the pedicles and strict screw insertion technique should be emphasised.

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REHABILITATION OF PATIENTS WITH SPINAL CORD INJURY AT THE LEVEL OF THE CERVICAL SPINE OPERATED BY OF PEDICLE SCREW FIXATION

Medical Science And Education Of Ural ◽

10.36361/1814-8999-2020-21-2-77-80 ◽

2020 ◽

Vol 21 (2) ◽

pp. 77-80

Author(s):

O.A. BORISOVA ◽

◽

K.S. SERGEEV ◽

O.N. DREVAL ◽

R.V. PASKOV ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Cord Injury

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Loss of correction in spinal cord injury-related scoliosis after pedicle screw fixation

Child s Nervous System ◽

10.1007/s00381-013-2316-0 ◽

2013 ◽

Vol 30 (4) ◽

pp. 673-680

Author(s):

Mina G. Safain ◽

Steven Hwang ◽

Joseph King ◽

Patrick Cahill ◽

Amer Samdani

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Loss Of Correction ◽

Cord Injury

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Development and Biomechanical Analysis of a New Anterior Cervical Pedicle Screw Fixation System

10.21203/rs.3.rs-150237/v1 ◽

2021 ◽

Author(s):

Maji Sun ◽

Qiuan Wang ◽

Xingchen Zhang ◽

Rui Zhao ◽

Kaijin Guo ◽

...

Keyword(s):

Cervical Spine ◽

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Cervical Pedicle Screw ◽

Cervical Pedicle ◽

Group B ◽

Group D ◽

Fixation System ◽

Better Than

Abstract ObjectiveA new anterior cervical pedicle screw fixation system was developed based on the relevant anatomical structure of the cervical spine, and its biomechanical properties were evaluated on fresh cadaver cervical spine specimens to provide a basis for preliminary clinical application. MethodsThree-dimensional parameters of the new nail plate system were obtained from the anatomical data of cervical spine specimens, and the system was produced by 3D printing technology. Fresh adult cadaver cervical spine specimens were used to measure biomechanical stability in the intact state (group A: complete group) and to establish a C5-7 instability model in which fixation with the traditional cervical anterior nail plate system was performed (group B). Anterior cervical spine displacement, strength, stiffness, torsion torque, etc. were measured under the fixed state when 4 screws were used for fixation with the pedicle screw system (group C) and 6 screws were used for the anterior cervical pedicle screw system (group D). ResultsIn terms of the load-displacement relationship, the results showed that the average displacement difference between group D and group C after the test was 25%, that between group D and group B was 30%, that between groups C and B was 18%, and the differences were statistically significant (P <0.05). In terms of the axial stiffness of the cervical spine, that of group D was 20% higher than that of group C and 40% higher than that of group B, that of group C was 20% higher than that of group B when fixed, and those of group D and C were both better than that of group A, the blank control group; all the differences were statistically significant (P<0.05). In terms of torsion mechanical properties of the cervical spine, the experimental results showed that that of group D was higher than that of group C by 21% and higher than that of group B by 40%, that of group C was higher than that of group B by 30%, and the differences were statistically significant (P<0.05). The biomechanical tests showed that in terms of load-displacement, axial stiffness and torsional mechanical properties, the anterior cervical pedicle locking and guiding internal fixation system was slightly better than the complete method. The 6 nail fixation method was better than the 4 nail fixation method. ConclusionThe new anterior cervical pedicle screw fixation system conforms to the anatomy of Chinese individuals and has better mechanical stability than do traditional fixation methods. It is a new, reliable anterior cervical pedicle internal fixation system for clinical practice.List of Abbreviations: ACPS: anterior cervical pedicle screw.

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