Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (4): 642-646.doi: 10.3969/j.issn.1673-8225.2012.04.017

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The clinical efficacy of application of posterior screw internal fixation system in instable axis fractures

Wei Hai-feng1, Teng Hong-lin2, Bian Jian1, Li Hai-jun1, Chen Chun-mao1   

  1. 1Department of Spinal Surgery, Taizhou People’s Hospital, Taizhou  225300, Jiangsu Province, China; 2Department of Spinal Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou  325000, Zhejiang Province, China
  • Received:2011-09-19 Revised:2011-11-22 Online:2012-01-22 Published:2014-04-04
  • About author:Wei Hai-feng☆, Doctor, Attending physician, Department of Spinal Surgery, Taizhou People’s Hospital, Taizhou 225300, Jiangsu Province, China wei.hf2004@163.com

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Abstract:

BACKGROUND: During posterior screw-rod internal fixation of upper cervical spine, placement of atlas lateral mass screw is the key technology.
OBJECTIVE: To summarize entrance point for screw insertion of posterior screw-rod internal fixation system in instable axis fractures.
METHODS: From January 2007 to December 2010, nineteen patients with instable axis fractures, including 12 males and 7 females, with an average age of 49.5 years (range, 21-75 years), were treated with Vertex posterior screw-rod internal fixation. Atlas lateral masses screw and axis pedicle screw were performed in 6 cases for internal fixation. Atlas lateral masses screw, single axis pedicle screw and neck 3 lateral masses screw were performed in 3 cases for internal fixation. Atlas lateral masses screw, double axis pedicle screws and neck 3 lateral masses screw were performed in 1 case for internal fixation. Axis pedicle screw and neck 3 lateral masses screw were performed in 9 cases for internal fixation. Fusion technique was performed in all cases.
RESULTS AND CONCLUSION: Nineteen patients were followed up from 7 to 43 months. All cases had satisfactory reduction and healing in the positions of axis fractures, fusion rate in the positions of bone grafts was 100%. There were no screw and rod breakage, and no iatrogenic injury of spinal cord and vertebral artery happened. The method for the treatment of instable axis fractures is little trauma and reliable fixation. The authors according to clinical experiences, entrance point for screw insertion are summarized as follows: ①The entrance point of atlas lateral masses screw is slightly outer side in the lateral mass midpoint, at the bottom 1/3 of vertebral arch. Direction of needle is inward and upward slightly tilted about 10° and 5°. ②The entrance point of axis pedicle screw is between the upper and lower articular surface of axial, the midpoint of the middle vertical line of subtalar joint. Direction of needle is inward and upward slightly tilted about 15°-20° and 25°. ③The entrance point of neck 3 lateral masses screw is 2 mm inside of lateral mass center. Direction of needle is inward and upward slightly tilted about 20°-25°.

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