The Posterior Surgery Efficacy Of The Cervicothoracic Junction Lesions

Objective To investigate posterior decompression, the lesions cleared,between vertebral body bone, cervical lateral mass screw combined withthoracic pedicle screw internal fixation system in treatment of the clinicalcurative effect of cervicothoracic spinal lesions.Methods A retrospective analysis from January2009to March2012during the19patients with cervicothoracic spinal lesions (fracture in5cases,4cases of tuberculosis, tumor,10cases),13cases of male, female6cases; Aged22to73years old, average48.6years. Adopt after posteriorinternal fixation surgery, through ASIA, preoperative and follow-upimproved classification to evaluate the surgical curative effect.Results This group of intraoperative blood loss,120-1100ml,420ml;average Operation time,70-260min,150min on average. Of19cases of1case of intraoperative findings epidural cyst rupture, previously consideredfor preoperative small fracture block wear out, intraoperative previously torepair, no postoperative cerebrospinal fluid leakage.18patients withincision and drainage pipe meet the grade a healing.1case of tuberculosisin patients with incision fistula, the chemotherapy and strengthen the treatment actively, class a healing of incision after3weeks.19casesreceived outpatient was12to32months, the bone graft fusion blocks are3to4months,19cases cervical segmental spinal physiological radian shallrecover, with no one screw loose, fall off, the complications such as rupture.1cases of bone tumor of prostate postoperative local recurrence one year,another1case of breast cancer metastatic bone tumor local recurrence2years later. ASIA grade A level2cases of postoperative neurologicsymptoms level1B,2C in1case; B level6cases of postoperativerecovery to the C level in2cases,3D and E in1case. Class C5cases ofpostoperative recovery to2D, and E (3cases); D4patients ofpostoperative recovery to E. With sympathetic ganglion stimulus symptomsabated. The average follow-up of19.8months. Spinal cord functionalrecovery in AISA classification to improve the level of2.8on average.Conclusion Cervicothoracic spinal lesions with simple posterior,cervical lateral mass screw combined and thoracic pedicle screw internalfixation system treatment can get good show, with the features of easyoperation, intraoperative decompression thoroughly, reliable fixation, highrate of postoperative bone graft fusion. The internal fixation systemconform to the requirements of the stability of the spine biomechanics, iscervical segmental spinal injury and effective surgical treatment method.