Clinical Application Of Cervical Lateral Mass Screws In The Cervical Vertebra Disease

Objective: To investigate the efficacy and safety of cervical lateral mass screw fixation in the treatment of cervical spine disease by reviewing 30 cases of patients with posterior cervical spine surgery.Methods: In July 2012-2015 June 30 patients with cervical lateral mass screws in fixation for the treatment of cervical vertebra disease patients were retrospective study(in this group of patients in the cervical spine injury in 16 cases,Multi segment cervical spondylosis of 12 cases,cervical ossification of the posterior longitudinal ligament(1 cases),cervical spinal dural spontaneous bleeding in 1 case).All patients were treated with posterior decompression and lateral mass screw fixation.Among them,2 cases were considered to be due to the cervical cord anterior nucleus pulposus compression,the two stage of anterior nucleus pulposus removal and bone graft fusion titanium plate internal fixation.All the cases were in the preoperative,postoperative and after 6 months the Asia score and JOA scoring system in patients with neurological symptoms for clinical effect assessment,patients were followed up for reset graft bone fusion and internal fixation failure.Results: All 30 cases of patients with follow-up,were followed up for 6 months to3.5 years,average 2 years 4 months.Postoperative X-ray radiography,cervical spine MRI;All patients with cervical spine were completely reset.Six months after all patients obtained good bony fusion.16 patients with cervical vertebra trauma(ASIA hierarchical),5 cases of grade A()incomplete cervical spinal injury patients,1 case 6months after died of respiratory failure caused by repeated pulmonary infection,2cases of return to class B,2 cases without recovery;5 B patients,4 cases of return to class C,1 case without recovery;In 4 patients with grade C,3 cases back to E,1 case of recovery to D;2 D patients return to E.Preoperative and postoperative June 2weeks and postoperative ASIA grading Kruskal Wallis test P = 0.049.Group between two comparison shows that there was no significant difference compared preoperative and postoperative 2 weeks(P = 0.829),preoperative and postoperative JOA score June comparative differences are significant(P = 0.024);Segmental myelopathic type was more longitudinal ligament ossification after 12 cases of cervical spondylosis and cervical spine in 1 case,cervical epidural tube spontaneous bleeding in 1 case,optimal 9 cases(period > 75%),4 cases were good period(50% 75%),can be in 1case(period < 50%).Preoperative and postoperative June 2 weeks and postoperative JOA scores have significant difference comparison,P = < 0.001(F = 23.13).Comparison between groups showed preoperative and postoperative JOA score there was no significant difference comparing the 2 weeks(P = 0.087),preoperative and postoperative JOA score June comparative differences are significant(P < 0.001).All cases are no nerve root,vertebral artery,the complications of spinal cord injury or damage is aggravating.Conclusion: Cervical lateral mass screws in fixation with reduction effect,wide indications,the advantages of safe operation,postoperative largely retained the activity of patients with cervical degree,cervical spine surgery is a safe and reliable internal fixation method.