변형된 Magerl's 방법을 통한 경추 후방 외측괴에 나사못과 금속판 고정의 임상 및 방사선학적인 안전성

초록

Objectives: To determine the radiological safety in 12 consecutive patients managed with a plate and screw fixation system applied to lateral mass and T1, T2 pedicle area. Methods: 12 patients who underwent posterior cervical arthrodesis were reviewed, from Jan. 2002 to Dec. 2003. Posterior cervical screw and plate fixation were applied on the lateral mass of cervical area and pedicle of T1 spine. The authors have tried 20-30 degree lateral-30degree rostral screw trajectory on the lateral mass and 20-30 degree medial-15 degree caudal screw trajectory on the T1 pedicle area. Computed tomography scans taken after surgery were reviewed whether attempted screw trajectory was correct and safety was guaranteed. Results: Two of 46 lateral mass screw were malpositioned but clinical damage was not noted. Two of 8 pedicle screw on the T, T2 were not placed on the correct pedicle area. Screw and plate loosening was showed on a one case. A case who showed screw loosening was not additional procedure because of being controlled with medication. Conclusion: 4.3% malposition of lateral mass plating and 25% incorrect screw of pedicle screwon the T1 area was observed though no spinal cord injury or vertebral artery injury. Chance of incorrect screws was higher in the T1 pedicle screw fixation than lateral mass screw fixation on the cervical area.