頚椎外側塊プレートの使用経験

Abstract

A retrospective clinical and radiographic analysis was perfomed on 5 patients who were treated with lateral mass plate. The average patients age was 46.8 years (range, 22-78 years), and the average follow-up period was 10 months (range, 3-20 months). Three patients with dislocation and fracture of the cervical spine were treated with posterior plate without bone graft, and with decompression and anterior plate with iliac crest bone graft. One patient with C456 body fracture and C345 lamina fracture was treated with posterior plate with bone graft. One patient with cervical myelopathy with athetosis was treated with long posterior plate (C2-T1) with bone graft. After surgery, the patient's neck was protected with a soft collar while in bed, and a philadelphia collar was worn when ambulating for the first month, then a neck collar for Next two months. Solid arthrodesis was achieved in all. No patients experienced neurological deterioration. However, some loosening screws and some malpositioned screws were found by the CT scans and X-ray, due to poor operative technique. Although there was no clinical symptom, one patient underwent additional operative procedure to replace two screws. We conclude that lateral mass plating is a good method for cervical spine stabilization if we are able to master the surgical technique well.