虽然C1螺钉固定越来越流行,只有少数研究讨论了C1螺钉并发症的危险因素和模式.
探讨C1螺钉并发症的发生率,分析C1螺钉并发症的危险因素。
分析了180例连续患者中358枚C1螺钉的C1螺钉并发症。螺钉错位,枕骨神经痛,主要并发症,并对C1螺钉总并发症进行分析。
C1螺钉入口点的分布如下:下侧质量,317个螺钉(88.5%);后弓(PA),38个螺钉(10.7%);和上侧块,3个螺钉(0.8%)。我们为127个螺钉(35.5%)牺牲了C2根部。C1仪器引起3.1%螺钉错位,6.4%枕神经痛,0.6%血管损伤,和3.4%的主要并发症。在多变量分析中,畸形(赔率比[OR]:2.10,P=0.003),创伤性病理学(OR:4.97,P=.001),和PA进入点(OR:3.38,P=.001)是C1螺钉错位的独立因素。C2根切除可降低C1螺钉错位的发生率(OR:0.38,P=.012),但它是枕神经痛的危险因素(OR:2.62,P=0.034)。先进的手术经验(OR:0.09,P=0.020)与较少的主要并发症相关。
C1螺钉并发症的发生率可能并不少见,畸形或创伤性病理和PA进入点可能是C1螺钉总并发症的危险因素。PA螺钉引起更多的错位,但枕骨神经痛较少。C2根切除可以减少螺钉错位,而是增加枕骨神经痛.
Although C1 screw fixation is becoming popular, only a few studies have discussed about the risk factors and the patterns of C1 screw complications.
To investigate the incidence of C1 screw complications and analyze the risk factors of the C1 screw complications.
A total of 358 C1 screws in 180 consecutive patients were analyzed for C1 screw complications. Screw malposition, occipital neuralgia, major complications, and total C1 screw complications were analyzed.
The distribution of C1 screw entry point is as follows: inferior lateral mass, 317 screws (88.5 %); posterior arch (PA), 38 screws (10.7 %); and superior lateral mass, 3 screws (0.8 %). We sacrificed the C2 root for 127 screws (35.5 %). C1 instrumentation induced 3.1 % screw malposition, 6.4 % occipital neuralgia, 0.6 % vascular injury, and 3.4 % major complications. In multivariate analysis, deformity (odds ratio [OR]: 2.10, P = .003), traumatic pathology (OR: 4.97, P = .001), and PA entry point (OR: 3.38, P = .001) are independent factors of C1 screw malposition. C2 root resection can decrease the incidence of C1 screw malposition (OR: 0.38, P = .012), but it is a risk factor of occipital neuralgia (OR: 2.62, P = .034). Advanced surgical experience (OR: 0.09, P = .020) correlated with less major complication.
The incidence of C1 screw complications might not be uncommon, and deformity or traumatic pathology and PA entry point could be the risk factors to total C1 screw complications. The PA screw induces more malposition, but less occipital neuralgia. C2 root resection can reduce screw malposition, but increases occipital neuralgia.