Imaging measurement and feasibility analysis of micro-titanium plate combined with lateral mass screw internal fixation in posterior cervical single-door surgery
Imaging measurement and feasibility analysis of micro-titanium plate combined with lateral mass screw internal fixation in posterior cervical single-door surgery
Objective To measure the imaging parameters related to cervical lateral mass using the picture archiving and communication system(PACS),and compare the effect of the position relationship between micro-titanium plates and lateral mass screws on the success rate of screw placement in micro-titanium plate combined with lateral mass screw internal fixation surgery.Methods From September 2021 to December 2021,the cervical CT data of 116 patients who underwent cervical CT examination at the orthopedic outpatient department of the General Hospital of Northern Theater Command were collected and transmitted to PACS.The posterior surface length(PSL)and lower pole angle(LPA)of the C3-7 lateral masses were measured.The micro-titanium plate combined with 4 types of lateral mass screw placement techniques(Roy-Camille,Magerl,Riew and Cheng techniques)were simulated,and the minimum required PSL without damaging the articular process was calculated.If the calculated value was less than the actual PSL,it was defined as successful screw placement;otherwise,it was defined as failed screw placement.According to the position relationship between the micro-titanium plate and the lateral mass screw,the patients were divided into upper group(the micro-titanium plate was located above the lateral mass screw)and lower group(the micro-titanium plate was located below the lateral mass screw),and the differences in the success rate of screw placement between the groups were compared.The minimum required PSL for the groups with higher success rates of screw placement in the different screw placement techniques was calculated.Results The success rate of screw placement was 17.4％in the Magerl upper group and 0.2％in the Magerl lower group.The success rate of screw placement was 60.5％in the Camille upper group and 0.2％in the Camille lower group.The success rate of screw placement was 69.3％in the Riew upper group and 0 in the Riew lower group.The success rate of screw placement was 85.2％in the Cheng upper group and 0 in the Cheng lower group.The overall success rate of screw placement of upper groups was 58.1％,and the overall success rate of screw placement of lover group was 0.1％.Overall,the success rate of screw placement in the upper group was higher than that in the lower group in different screw placement techniques,and the difference was statistically significant(P＜0.05).The minimum required PSL for Magerl upper group was 15.6 mm,Camille upper group 13.1 mm,Riew technical upper group 12.5 mm,and Cheng upper group 11.5 mm.Conclusions Among the micro-titanium plates combined with lateral mass screw placement techniques,the success rate of screw placement was higher when the micro-titanium plate was placed over the lateral mass screws.Among them,the Riew upper group and the Cheng upper group both have a higher success rate of screw placement,which suggest that the micro-titanium plate located above the lateral mass is a feasible and relatively safe strategy in posterior cervical single-door plate-screw internal fixation.However,it is not recommended to perform combined surgery if the PSL of the cervical lateral mass less than 11.5 mm.
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