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《Journal of Spinal Surgery》 2011-03
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Clinical application of pedicle screw in atlas using pedicle exposure method

TAN Ming-sheng,TANG Xiang-sheng,YI Ping,YANG Feng.Department of Spine Surgery,China-Japan Friendship Hospital,Beijing 100029,China  
Objective To explore the surgical feasibility and clinical outcome of pedicle screw in atlas by pedicle exposure method(PEM).Methods Forty-six patients with atlas dislocation were treated surgically with pedicle screw by a revised technique.The patients received preoperative CT,MRI and radiograph examination.The heights of posterior arch were 2.5-4.0 mm,with an average of 3.1 mm.Results All the 92 screws were successfully placed in the atlas of 46 patients and obtained satisfactory fixation.Thirty-six patients were followed up for 3-42 months,with an average of 18.6 months.Bony fusion was observed in all the 36 cases within 3-6 months;there were no complications such as internal fixation failure or redislocation of atlas.Two screws penetrated into the medial rim of the vertebral artery foramen,but caused no vertebral artery injury.Neurological function was greatly improved in 31 cases,and became better in 5 cases.Conclusion Application of pedicle screw in atlas by pedicle exposure method is surgically feasible,with highly accurate and safe insertion of the screw;the method is suitable for patients with the height of posterior arch 4 mm,especially for children.
【CateGory Index】: R687.3
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