C7 intra-laminar screws for advanced cervicothoracic backbone surgery-a case collection.
J Backbone Surg. 2017 Dec;three(four):561-566
Authors: Wilson PJ, Selby MD
Background: C7 has comparatively distinctive anatomy in comparison with the rest of the subaxial cervical backbone (C3-C6) and higher thoracic backbone. The C7 laminar has been beforehand reported in feasibility and biomechanical research as an enough fixation level in distinction to the lateral mass or pedicles, with few studies of its use in medical apply. The aim of this examine was to evaluation the security and efficacy of utilizing the C7 laminar as a fixation level in constructs involving the cervical backbone and cervicothoracic junction.
Strategies: Between February 2013 and July 2016, 10 sufferers (6 males, four females) had 19 C7 intra-laminar screws sited (bilateral in 9 sufferers, unilateral in 1 affected person). Six sufferers had trauma as an underlying etiology, 2 of which had pseudoarthrosis from prior surgical procedure. Three sufferers had cervical myelopathy from degenerative illness, 2 of which required anterior and posterior instrumentation for correction of deformity and 1 which had stand-alone posterior fixation. One affected person had stabilization for an underlying malignancy.
Outcomes: One affected person died 2 weeks following their excessive cervical harm secondary to problems of respiratory failure. Not one of the remaining 9 sufferers had been famous to have assemble failure at a median observe up of 1 yr (vary, 6 months to four years) and all had been famous to have passable positioning of the instrumentation on post-operative imaging. The affected person with malignancy died 6 months later from extra-spinal illness, there was one wound breakdown requiring debridement with out an infection in a revision case, and one affected person required laminectomy for post-traumatic syrinx formation.
Conclusions: The C7 laminar gives an alternate fixation level for constructs involving the subaxial cervical backbone and cervicothoracic junction, with wonderful security and efficacy on this small collection. Bigger collection are required to extra make clear the danger profile of this method.
PMID: 29354732 [PubMed]