Compression fixation for neck 2 spondylolisthesis

Curing disease: Indication The compression fixation of the neck 2 slip is suitable for: 1. Can not withstand the external fixation or the occurrence of nonunion of the neck 2 fracture. 2. Traumatic neck 2 slippage which can be completely restored but unstable by traction, and is not accompanied by rupture or displacement of 2~3 discs. Preoperative preparation Anesthesia and position Anesthesia was performed with local anesthesia or tracheal intubation. Prone position, head traction to maintain the reduction of the fracture. Surgical procedure 1. The posterior median approach reveals the posterior structure of the upper cervical spine. The position of the neck 2 side block is determined by the neck 2 and 3 joints. Under the surveillance of the image intensifier, two 1.2 mm K-wires were drilled into the lateral protrusion in the direction of the flank of the parallel neck 2 to 3 through the midpoint of the lateral joint of the neck 2 joint. A thin stripper can be inserted into the facet joint to assist in determining the direction of the sagittal plane in which the Kirschner wire is drilled. In the horizontal plane, the Kirschner wire should be 15° to 25° from the center line. The cervical 2 lamina and the medial cortical bone of the isthmus were marked with a stripper to determine the horizontal direction of the Kirschner wire. 2. Two Kirschner wires drilled can maintain fracture reduction. The Kirschner wire was removed one by one and two 3.5 mm cortical bone screws were screwed in by compression. First, the hole was reamed with a 2.0 mm drill bit, and the proximal portion was further enlarged with a 3.5 mm drill bit to create a sliding bone hole to facilitate compression at the fracture end when the screw was screwed in. 3. Check the stability of the fixed cervical vertebra by an image intensifier. If it is necessary to strengthen the neck 2 and 3 sections, a short AO steel plate or hook steel plate can be added to the neck 2 screw. The stability of the neck 2 and 3 segments can also be enhanced by the interspinous wire.