Different Internal Fixation Methods For Adult Type ? Dentate Sudden Fresh Fractures Of Cervical Stability Of Two-thirds Of The Research

The first part of anterior cervical hollow compression screws fixation and cervical posterior atlanto-axial vertebral pedicle screw fixation for treatment of type ? dentate processes in fresh fractures of cervical stability of two-thirds of the biomechanics researchObjective: this study intends to through to the adult ? dentate processes in fresh fractures after anterior cervical hollow compression screws fixation and cervical posterior atlanto-axial postoperative cervical vertebral pedicle screw internal fixation 2,3,biomechanical experimental results were analyzed,and the validation and evaluation type ? dentate tu use fresh fractures after surgical treatment of different internal fixation methods influence on the stability of the neck,2,3,for clinical type ? dentate processes fresh fracture surgery for maximum avoid affecting adjacent segmental stability provides theory basis.Methods: 14 fresh adult cadaver specimens from the department of anatomy,southern medical university were selected.The muscle and fascia were completely removed from the cadaver,and the ligament structure and joint capsule were completely preserved.Macroscopic examination showed no obvious bone destruction or deformity.Before inclusion in this study,the defect of bone structure was excluded by the positive and lateral X-ray radiography.After specimen preparation,the specimens were divided into two groups: anterior cervical dentate process screw internal fixation group A and posterior cervical atlantoaxial pedicle screw internal fixation group B.By comparing the biomechanical study and measuring the biomechanical test results of 2 and 3 segments of posterior cervical nailing with different internal fixation methods before and after fracture,the lateral bending load experiments of rotation,front,back,left and right directions of the specimens in each group were conducted,and the load-displacement curve results were obtained.Specimens in groups A and B were prepared after the completion of the complete cervical spine specimen biomechanical experiment to ensure the integrity and effectiveness of specimens.Results: Under the same stress load,fracture type ? dentate processes compared with intact specimens of normal control group,group activity(C2 and C3)values before and after the left lateral flexion,flexion and rotation around the differences have statistical significance,shows dentate sudden fracture itself impact on the stability of carotid 2-3,dentate condyle fracture before fracture,fracture,anterior cervical hollow compression screw internal fixation group and the cervical posterior atlanto-axial vertebral pedicle screw internal fixation group activity(C2 and C3)value,is different in every direction have statistical significance,the fracture group > normal group > posterior group > before,Prompt clinical treatment ? type DCS bone tooth DCS anterior fixation of fracture specimens under stress direction five specimens of the posterior atlanto-axial vertebral pedicle screw movement a smaller,difference have statistical significance(P < 0.05).Anterior cervical hollow compression screws fixation and cervical posterior atlanto-axial vertebral pedicle screw internal fixation can provide good biomechanics and strong internal fixation,anterior cervical hollow compression screws fixation and cervical posterior atlanto-axial vertebral pedicle screw internal fixation technique can be effectively used for type ? dentate fresh fracture surgery.However,the postoperative stress of anterior cervical spine is less concentrated in the adjacent segments,which can better avoid the occurrence of the instability of adjacent cervical 2 and 3.Conclusion: the continuity and integrity of the dentate process play an important role in maintaining the stability of the upper cervical spine.Dentate sudden fracture by anterior cervical hollow compression screws fixation and cervical posterior atlanto-axial vertebral pedicle screw internal fixation technique were has advantages of easy operation,high safety coefficient,the cervical anterior teeth,hollow compression screws fixation is cervical posterior atlanto-axial vertebral pedicle screw fixation less impact on the stability of adjacent segments.Anterior cervical hollow compression screw internal fixation and posterior cervical atlantoaxial pedicle screw internal fixation can be widely used in the surgical treatment of dentate process fractures,but anterior cervical hollow compression screw internal fixation has less impact on the stability of cervical 2 and 3 than posterior cervical atlantoaxial pedicle screw internal fixation.The second part of Imaging measurement of the approach point and Angle of modified atlas pedicle screw approachObjective: type ? dentate process fracture in the cervical spine injury is serious and common types,according to the type of damage is more classic treatment of premenstrual dentate tu hollow compression screw internal fixation and cervical posterior atlanto-axial vertebral pedicle screw internal fixation surgery.Posterior atlantoaxial pedicle screw fixation of cervical spine is easy to be complicated with spinal cord and vertebral artery injury.The purpose of this study was to investigate the value of three-dimensional CT reconstruction and computer measurement in the application of atlas pedicle screw fixation.Methods: select in December 2015 to December 2017 the first affiliated hospital of guangxi medical university,NO.181 hoapital of PLA,shunde,southern medical university hospital proposed by the atlas posterior pedicle nailing art of 42 cases of patients,all adopt 64 row helical CT atlas scan imaging,3 d reconstruction image post-processing and computer data measurement and nail design technology atlas pedicle nailing in safety area nailing.Results: bilateral pedicle width,extreme value(maximum,minimum)into the nail and nail(length,width),security area nailing(into the screw Angle,lateral boundary point distance,the distance between inside and outside world and atlas nodules after)there was no statistical significance(P > 0.05)difference comparison,is safe to hold radius of 1.75 mm screw,for security into the area.In this study,there were no vascular,spinal and nerve root injuries,and no pedicle fractures.Postoperative CT showed that the screw was in good position,located in the pedicle,and the medial and lateral cortex was not ruptured.The success rate of surgery was 100%.Conclusion:CT three-dimensional reconstruction and computer measurement assisted the guidance of the Angle and length of atlas pedicle screw placement,the safe screw placement area was defined,and the short-term and long-term efficacy was improved.The third part of different internal fixation surgery method for adult type ? fresh dentate sudden fracture to the research on the effects of cervical stability of 2,3Objective: Type ? dentate sudden fracture is serious on cervical spine injury types,different surgical method for near the effect on the stability of the cervical 2,3,has been controversial.Type of this study was to explore ? dentate fresh fractures,excluding compound injury,after anterior cervical hollow compression screws fixation and cervical posterior atlanto-axial vertebral pedicle screw internal fixation and bone graft fusion,through the preoperatie and follow-up interval two-thirds of cervical intervertebral disc height change and routine MRI scans and Pfirrmann grading follow-up measurement of intervertebral disc,consideration of the effect on the stability of the neck,2,3.Method: 1,review the first affiliated hospital of guangxi medical university,the NO.181 hospital of PLA,shunde,southern medical university hospital from January 2008 to March 2015 type of surgical treatment of adult fresh ? dentate,and 29 cases of fracture by preoperative cervical mouth side,cervical vertebrae and the cervical CT diagnose dentate ? fresh fractures,exclusion of atlanto-axial joint damage,neck fracture bow before and after a compound injury,such as parallel MRI examination of cervical vertebra,through routine MRI scan to rule out two-thirds of cervical intervertebral disc injury.Among them,there were 17 males and 12 females aged between 19 and 65(40).8-12.6 years old).Through the line of preoperative and postoperative follow-up of cervical intervertebral disc height change on June,December,combined with routine MRI scans and T2-mapping values and Pfirrmann grading follow-up measurement of intervertebral disc,evaluation of type ? dentate tu fractures of different surgical methods on the effect on the stability of the neck,2,3.Results: the height of cervical 2/3 intervertebral disc in patients with anterior cannulated compression screw internal fixation showed no significant change at 1 week and 6 months after surgery,and decreased at 12 months after surgery.In patients with posterior atlantoaxial pedicle screw internal fixation,the cervical disc height of 2/3 patients gradually decreased 6 months and 12 months after surgery,the difference between the two groups was not statistically significant(P>0.05).T2 value in the comparison of different degree of cervical intervertebral disc degeneration: 29 patients a total of 29 two-thirds of cervical intervertebral disc,by sorting Pfirrmann grading materials found anterior cervical hollow compression screw group 15 two-thirds of cervical intervertebral disc in 1 week after operation,postoperative June,December ?,?,?,?,V grade cases respectively,9,4,2,0,0and6,4,3,2,0and5,5,2,3,0 cases;Cervical posterior atlanto-axial vertebral pedicle screw internal fixation group,14 disc 1 week after surgery,postoperative June,December ?,?,?,?,V cases respectively,6,6,2,0,0and4,6,4,0,0and3,5,2,3,1 case.Conclusion: the anterior cervical hollow compression screw internal fixation and cervical posterior atlanto-axial vertebral pedicle screw internal fixation can provide good biomechanics and strong internal fixation,anterior cervical hollow compression screws fixation and cervical posterior atlanto-axial vertebral pedicle screw internal fixation technique can be effectively used for type ? dentate fresh fracture surgery.However,during and after the operation,it is necessary to strictly protect the structure of each part of cervical 2 and 3 and the integrity of intervertebral disc,and follow up closely,to prevent as far as possible the changes in the stability of cervical 2and3.