Anterior locking plate fixation

Anterior locking plate fixation for the treatment of spinal fracture and dislocation. Treatment of diseases: cervical vertebral body wedge compression fracture axial vertebral fracture Indication Anterior locking plate fixation is applicable to: 1. Single-segment dislocation injury without bone defect or vertebral compression fracture requires interbody fusion. 2. For the anterior column of the vertebral body due to severe wedge-shaped compression fracture or burst fracture, accompanied by neurological dysfunction, anterior decompression and bone grafting are required for vertebral body resection. Double-segment fixation is optional. This procedure increases the stability due to the interlocking of the screws and the steel plate (Fig. 3.26.5.14-2). It prevents the screws from loosening and does not need to penetrate the posterior wall of the vertebral body. Surgical procedure Reveal More than a transverse incision is used to expose the diseased vertebral body and intervertebral disc according to the anterior approach. Decompression or bone grafting is performed as needed. Removal of traction to check bone graft stability. 2. Select steel plate The size of the plate should ensure that the screw can penetrate the upper part of the vertebral body. It is necessary to prevent the screw from penetrating into the upper and lower intervertebral discs of the fusion plane, and the plate should be prevented from crossing the normal intervertebral disc. 3. Drilling Select the steel plate to place the best position. Guide the drill guide to drill the first screw hole with a 3mm drill. The length of the screw is 14mm, and the screw does not need to penetrate the back wall of the vertebral body, so the drilling does not need to be too deep, and the drilling depth is not more than 16mm. 4. Tapping With the aid of a soft tissue protection sleeve, tap the 4mm wire tap to a depth that does not exceed the depth of the pre-drilled hole. 5. Screw in the screw First insert the "Ten" prefix screwdriver into the screw head end, then put the split sleeve on the screw head to maintain the screw position, and also prevent the "Ten" shaped opening screw from being opened when screwed in. Screw the screw flush with the steel plate. As the screw is tightened, the sleeve will automatically retract, leaving only the screwdriver in place, but it is easy to remove. 6. Locked steel plate After all the screws are in good condition, follow the similar operation method above, and then screw in the conical head screws (locking screws). When the small screws are tightened, the large screw head will be large, and the steel plate and the screw will be tightly locked in place. The position of the steel plate and the depth of the screw can be checked with a C-arm X-ray machine. 7. Suture incision Wash the incision with saline, indwell the wash, and suture the incision in layers.