Posterior Bilateral Intermuscular Approach for Upper Cervical Spine Injuries.

Related Articles

Posterior Bilateral Intermuscular Approach for Upper Cervical Spine Injuries.

World Neurosurg. 2017 May 22;:

Authors: Xu Y, Xiong W, Han S, Fang Z, Li F

Abstract
OBJECTIVE: To investigate a novel intermuscular surgical approach for posterior upper cervical spine fixation.
METHODS: Twenty three healthy volunteers underwent MRI imaging. By using the MRI scans in transverse view at the level of lower edge of atlas, the distances from the posterior midline to lateral margin of trapezius (0-T), to the medial margin of splenius capitis (0-Spl), and to middle line of semispinalis capitis (0-Sem) were recorded. The angle between posterior middle line and the line crossing the lateral margin of trapezius and middle point of ipsilateral pedicles. From October 2009 to May 2013, 12 patients with upper cervical spine injuries were operated using the bilateral intermuscular approach. The time required for surgery, blood loss, and pre and postoperative Visual Analogue Scale (VAS) scores were analyzed.
RESULTS: The average distance of 0-T was 39.2±7.5 mm, the angle between the approach and posterior middle line was 33.2±8.4°. The surgical time was 78.3±22.5 minutes (45-140minutes), and the mean intraoperative blood loss was 87.5±44.2 mL (30-200 mL). Pre-operative and postoperative VAS scores were 6.4±0.8 and 1.8±0.7, respectively. The average follow-up time was 19.7±11.5 months (9-48 months).
CONCLUSIONS: The posterior bilateral intermuscular approach for upper cervical spine injuries is a valid alternative for Hangmans' fractures type I, type II and type Ia according to Levine and Edwards classification as well as atlantoaxial subluxation caused by upper cervical spine trauma.

PMID: 28546119 [PubMed - as supplied by publisher]

http://ift.tt/2r8i8wY