지원사업
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
- 2011.1
- 수록면
- 166 - 172 (7page)
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초록· 키워드
오류제보하기
Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.
목차
등록된 정보가 없습니다.
참고문헌 (14)
참고문헌 신청
Albert TJ / 1998 / Use of cervicothoracic junction pedicle screws for reconstruction of complex cervical spine pathology / Spine (Phila Pa 1976) 23:1596~1599
Ames CP / 2005 / Biomechanics of stabilization after cervicothoracic compression-flexion injury / Spine (Phila Pa 1976) 30:1505~1512
Cardoso MJ / 2009 / Using lamina screws as a salvage technique at C-7 : computed tomography and biomechanical analysis using cadaveric vertebrae. Laboratory investigation / J Neurosurg Spine 11:28~33
Cardoso MJ / 2008 / Computed tomography and biomechanical evaluation of screw fixation options at the cervicothoracic junction : intralamina versus intrapedicular techniques / Spine (Phila Pa 1976) 33:2612~2617
Cassinelli EH / 2006 / Anatomic considerations for the placement of C2 laminar screws / Spine (Phila Pa 1976) 31:2767~2771
Ames CP / 2005 / Biomechanics of stabilization after cervicothoracic compression-flexion injury / Spine (Phila Pa 1976) 30:1505~1512
Cardoso MJ / 2009 / Using lamina screws as a salvage technique at C-7 : computed tomography and biomechanical analysis using cadaveric vertebrae. Laboratory investigation / J Neurosurg Spine 11:28~33
Cardoso MJ / 2008 / Computed tomography and biomechanical evaluation of screw fixation options at the cervicothoracic junction : intralamina versus intrapedicular techniques / Spine (Phila Pa 1976) 33:2612~2617
Cassinelli EH / 2006 / Anatomic considerations for the placement of C2 laminar screws / Spine (Phila Pa 1976) 31:2767~2771
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