[Objective]To introduce the surgical technique and preliminary clinical results of posterior cervical laminar screw fixation for refractory cervical facet fracture and dislocation.[Methods]A total of 7 patients who failed to skull traction reduction of cervical facet fracture and dislocation were treated with posterior open reduction,laminar screw fixation and bone grafting.A posterior midline incision was made to reveal cervical spinous process,facet and ligaments.As paravertebral muscle of the dislocated side was retracted to the outer edge of the lateral mass,a total of 3 segments were exposed,including the affected,as well as the above and below adjacent segments.Ad-justing the traction weight and direction,the dislocated facet joint was reduced under the guidance of the nerve stripper.A universal screw was inserted into the contralateral lamina at the base of the spinous process aiming the center of the contralateral mass individually in the 3 segments.A linking rod was shaped and fastened with the 3 screws to finish fixation,with bone autograft placed on the affected side.[Re-sults]All patients were successfully operated on without nerve,vascular injury and other serious complications,while with operative time of(95.7±10.2)min,and intraoperative blood loss of(43.0±7.2)ml.All 8 facet fractures and dislocations in the 7 patients were reduced,with-out ventral laminar cortex perforated by screws.All of them had the involved segments fused with an average fusion time of(2.4±0.4)months,and no implant loosening and fracture,no re-dislocation were found in anyone of them.[Conclusion]Compared with the lateral mass screw fixation,the lamina screw fixation may be a more convenient,safe and feasible method for the treatment of irreducible cervical facet fracture and dislocation.
cervical spinefacet fracture and dislocationlaminar screw fixation
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