Cervical pedicle screw fixation for cervical spinal cord injury without fracture and dislocation
10.3760/cma.j.issn.1001-8050.2012.07.013
- VernacularTitle:颈椎椎弓根螺钉内固定治疗无骨折脱位型颈脊髓损伤
- Author:
Jianping KANG
;
Song WANG
;
Jun LI
;
Fei YE
;
Daxiong FENG
- Publication Type:Journal Article
- Keywords:
Spinal cord injuries;
Neck injuries;
Spinal stenosis;
Pedicle screw fixation
- From:
Chinese Journal of Trauma
2012;28(7):620-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the efficacy of cervical pedicle screw fixation in the treatment of cervical spinal cord injury without fracture and dislocation.Methods From September 2007 to March 2010,21 patients with cervical spinal cord injury without fracture and dislocation combined with developmental cervical stenosis were managed by pedicle screw fixation in unstable segments,and then single open-door laminoplasty in stenosis segments.The clinical outcomes were reviewed and summarized.Results All the patients received follow-up of 1-3 years.Two patients had superficial wound infection,which was cured by dressing change.One presented intra-incisional hematoma one week post-operatively and was cured by hemostasis and drainage.One had door-reclosing without symptom aggravation.There was neither perforation of pedicle screws nor breakage,loosening or displacement of internal fixation.The curvature of cervical lordosis at follow-up had significant rectification in comparison with that at preoperation,but showed unobvious change as compared with that immediately after operation.According to the modified Japanese Orthopedic Association (JOA) score,the neurological score improved from preoperative 4-15 points to 9-17 points at the final follow-up,which revealed more than 80％ of recovery in 13 patients,50％ -80％ of recovery in six and 5％ -50％ of recovery in two,with the average recovery rate of 75％.Conclusion For unstable segments in patients with cervical spinal cord injury without fracture and dislocation combined with developmental spinal stenosis,posterior pedicle screw fixation can avoid the risk of further spinal cord injury in single open-door laminoplasty and restore the physiological curvature of cervical vertebrae,which provides solid foundation for backward drift of spinal cord and creates favorable condition for recovery of spinal cord function.
