Posterior cervical spine arthrodesis with laminar screws

A report of two cases

Kazuo Nakanishi, Masato Tanaka, Yoshihisa Sugimoto, Toshihumi Ozaki

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We performed fixation using laminar screws in 2 patients in whom lateral mass screws, pedicle screws or transarticular screws could not be inserted. One was a 56-year-old woman who had anterior atlantoaxial subluxation (AAS). When a guide wire was inserted using an imaging guide, the hole bled massively. We thought the re-insertion of a guide wire or screw would thus increase the risk of vascular injury, so we used laminar screws. The other case was an 18-year-old man who had a hangman fracture. Preoperative magnetic resonance angiography showed occlusion of the left vertebral artery. A laminar screw was inserted into the patent side (i.e., the right side of C2). Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion, because the cervical pedicle is small and is adjacent laterally to the vertebral artery, medially to the spinal cord, and vertically to the nerve roots. Lateral mass screws are also reported to involve a risk of neurovascular injuries. The laminar screw method was thus thought to be useful, since arterial injuries could thus be avoided and it could also be used as a salvage modality for the previous misinsertion. Copyright

Original languageEnglish
Pages (from-to)115-119
Number of pages5
JournalActa Medica Okayama
Volume61
Issue number2
Publication statusPublished - Apr 2007

Fingerprint

Arthrodesis
Spine
Vertebral Artery
Spinal Fractures
Magnetic Resonance Angiography
Vascular System Injuries
Wounds and Injuries
Spinal Cord
Wire
Salvaging
Angiography
Pedicle Screws
Magnetic resonance

Keywords

  • Laminar screw
  • Lateral mass screw
  • Neurovascular complications
  • Pedicle screw
  • Transarticular screw

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Posterior cervical spine arthrodesis with laminar screws : A report of two cases. / Nakanishi, Kazuo; Tanaka, Masato; Sugimoto, Yoshihisa; Ozaki, Toshihumi.

In: Acta Medica Okayama, Vol. 61, No. 2, 04.2007, p. 115-119.

Research output: Contribution to journalArticle

Nakanishi, K, Tanaka, M, Sugimoto, Y & Ozaki, T 2007, 'Posterior cervical spine arthrodesis with laminar screws: A report of two cases', Acta Medica Okayama, vol. 61, no. 2, pp. 115-119.
Nakanishi, Kazuo ; Tanaka, Masato ; Sugimoto, Yoshihisa ; Ozaki, Toshihumi. / Posterior cervical spine arthrodesis with laminar screws : A report of two cases. In: Acta Medica Okayama. 2007 ; Vol. 61, No. 2. pp. 115-119.
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