Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique.

摘要: Articular mass fracture-separation accounts for 9% of the fractures lower cervical spine. Neurologic complications are frequent and usually radicular in nature. Unreduced, these may cause persistent neck pain. The treatment is surgical, fusing two or three vertebrae. In this article we present a new modality using reduction stabilization dislocated fragment with transpedicular lag screw. Previous anatomic studies have shown that pedicles spine wide enough to accept 4.0-mm screws. An study was performed showing screw fixation safe when following technique used: entry point 3 mm beneath facet joint on vertical line middle articular mass. drill angled medially, depending preoperative measurement computed tomography scan (average 45 degrees). aims toward cranial third vertebral body as seen lateral fluoroscopy. tap-drilling method used. After placement 33 screws cadaver spine, 10 had minor breakout cortex pedicle (only small parts threads were penetrating cortex); none showed major violation wall. most common direction lateral. Transpedicular has been successfully used patients.