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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
- 503 - 508 (6page)
이용수
초록· 키워드
오류제보하기
Objective : Anterior odontoid screw fixation is a safe and effective method for the treatment of odontoid fractures. The surgical technique is recommended for perforation of the apical cortex of the dens by the lag screw. However, overpenetration of the apical cortex may lead to potentially serious complications such as damages of adjacent vascular and neural structures. The purpose of this study was to assess the role of three-dimensional computed tomography (CT) scan to evaluate the safe margin beyond dens tip to ventral dura for anterior odontoid screw fixation. Methods : We retrospectively analyzed the three-dimensional CT scans of the cervical spines in 55 consecutive patients at our trauma center. The patients included 38 males and 17 females aged between 22 and 73 years (mean age${\pm}$standard deviation, $45.8{\pm}14.2years$). Using sagittal images of 3-dimensional CT scan, the safe margins beyond dens tip to ventral dura as well as the appropriate screw length were measured. Results : The mean width of the apical dens tip was $9.6{\pm}1.1mm$. The mean lengths from the screw entry point to the apical dens tip and posterior end of dens tip were $39.2{\pm}2.6mm$ and $36.6{\pm}2.4mm$. The safe margin beyond apical dens tip to ventral dura was $7.7{\pm}1.7mm$. However, the safe margin beyond the posterior end of dens tip to ventral dura was decreased to $2.1{\pm}3.2mm$, which was statistically significant (p<0.01). There were no significant differences of safe margins beyond dens tip to ventral dura with patient gender and age. Conclusion : Extension by several millimeters beyond the dens tip is safe, if the trajectory of anterior odontoid screw is targeted at the apical dens tip. However, if the trajectory of the screw is targeted to the posterior end of dens tip, extension beyond dens tip may lead to damage immediately adjacent to the vental dura mater.
목차
등록된 정보가 없습니다.
참고문헌 (17)
참고문헌 신청
Andersson S / 2000 / Odontoid fractures: high complication rate associated with anterior screw fixation in the elderly / Eur Spine J 9:56~59
Apfelbaum RI / 2000 / Direct anterior screw fixation for recent and remote odontoid fractures / J Neurosurg 93(2 Suppl):227~236
Assari S / 2012 / Biomechanical analysis of second-generation headless compression screws / Injury 43:1159~1165
Borm W / 2003 / Anterior screw fixation in type II odontoid fractures: is there a difference in outcome between age groups? / Neurosurgery 52:1089~1092
Chang KW / 1994 / One Herbert double-threaded compression screw fixation of displaced type II odontoid fractures / J Spinal Disord 7:62~69
Apfelbaum RI / 2000 / Direct anterior screw fixation for recent and remote odontoid fractures / J Neurosurg 93(2 Suppl):227~236
Assari S / 2012 / Biomechanical analysis of second-generation headless compression screws / Injury 43:1159~1165
Borm W / 2003 / Anterior screw fixation in type II odontoid fractures: is there a difference in outcome between age groups? / Neurosurgery 52:1089~1092
Chang KW / 1994 / One Herbert double-threaded compression screw fixation of displaced type II odontoid fractures / J Spinal Disord 7:62~69
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