Clinical Value Of Transpedicular Screw Fixation In Treatment Of15Lower Cervical Fractures And Dislocations

Objective：To investigate the clinical value of cervical pedicle screwsapplicated in the treatment of lower cervical fractures and dislocationspatients.Methods：Since February,2009to December,2011, fifteen patientswith lower cervical fractures and dislocations were treated bytranspedicular screw fixation technique in our hospital, the second people’shospital of Chongqing. We fixed the pedicle screws with dredging pipemethod, investigated the location of the screws and complications aftersurgery. All the patients were followed up the nerve condition by Frankelcriteria system, and were evaluated radiographically for the location of thefixation system.Results：All patients recovered from the surgery and the relocation ofcervical were excellent. Among the sixty-eight inserted screws, sixty-threescrews(92.6%) were completely inside the vertebral pedicle on thepostoperative CT scanning. The other five screws perforated the pediclewall, without any complication about injury of spinal cord, nerve root or vertebral artery. The pedicle screw system fixed well on the X-ray afteroperation with follow-up of three to twenty-eight months. The spinal cordfunction was improved at different degree in all patients, excepting twopatients whose Frankel scales were A.Conclusion：The pedicle screw system can provide tri-column fixationand distinct biomechanical stability. Transpedicular screw fixation incervical diseases was considered as a high risk and difficult operation in thepast, but its complications could be prevented by careful preoperativedesign, familiar with cervical topography and skillful surgery manipulation.So transpedicular screw fixation is a clinical feasible alternative in thetreatment of lower cervical fractures and dislocations.