3-wire fixation pillow-C3 fusion

Three wire fixation occipital ~ C3 fusion surgery for cervical spine injury. Children with cervical spine injury are rare, with 1% of fractures in children with cervical spine injury reported in the literature, or only 2% of children with spinal injury. 70% of them occur in the atlas and the axilla (the adult C1 and C2 injuries account for only 16% of cervical spine injuries). And children with cervical spine fracture often combined with spinal cord injury, but its prognosis is better than adults. Fielding and Hawkins classify atlantoaxial spine subluxation into four types. Type I is a simple forward rotation shift; Type II is a forward rotation shift combined with a forward shift of 3 to 5 mm; Type III is a forward rotation shift combined with a forward shift of >5 mm; Type IV is a backward rotation shift Bit. Treatment of diseases: atlas fractures and atlas fractures and dislocations Indication 3 wire fixation pillows ~ C3 fusion is suitable for: 1. The occipital neck is unstable, and the components of the posterior side of C1 and C2 are older. 2. With symptoms of nerve compression, or with intractable pain by non-surgical treatment. 3. Atlas fracture, instability of the upper cervical spine caused by injury of the transverse ligament of the atlas, with or without cervical spinal cord compression. 4. Acute sputum-occipital dislocation survivors. Surgical procedure Incision From the occipital bulge to the C3 for the posterior median incision, intradermal injection of 1:500,000 U adrenaline to help stop bleeding. 2. Reveal the occipital bone to C3 Sharpness separates the paraspinal muscle from the periosteum, and then uses the osteotome to make the suboccipital dissection to reveal the occipital bone and the C1C3 lamina. Pay special attention not to deviate too far from the midline to avoid damage to the median venous plexus. 2cm above the edge of the occipital bone, a hole is drilled horizontally on the occipital protuberance with a high-speed diamond drill bit, running through the two sides of the occipital protuberance, and the iliac crest is located in the center of the two holes, only drilling through the skull. board. 3. Bone grafting and fixation The 20th thick steel wire is used, the first one passes through the outer bulge of the occipital nucleus, and the bulge is wrapped around the occipital ridge once; the other wire is folded in half and surrounds the posterior arch of the atlas, and the two tail ends are respectively placed on the atlas. The two sides of the posterior tuberosity; the third wire passes through the bore of the spinous process root. Cut the full-thick patella strip into the appropriate length and width, cut into 2 pieces and make a slight curvature. Drill 3 holes in the appropriate position of each bone graft, pass the 3 wires on each side of the neck pillow through the holes in the bone graft, make the cortical bone of the occipital bone into a rough surface, and place the bone graft on the occipital bone. And on both sides of the spinous process, tighten the above three wires. Excess pineal bone is planted around the two bone grafts. After the drainage is placed, the incision is closed layer by layer.

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