Novel treatment (new drug/intervention; established drug/procedure in new situation): Cervical pedicle screw fixation in traumatic cervical subluxation after laminectomy using the pedicle axis view technique under fluoroscopy

摘要

Cervical pedicle screw (CPS) fixation has recently been performed in patients in need of cervical reconstruction. We report the case of a 50-year-old man who was operated for traumatic cervical vertebra subluxation using CPS fixation, in whom laminectomy had been performed in the past. We performed CPS fixation using the pedicle axis view technique under fluoroscopy. The four pedicle screws were accurately inserted within the pedicles without perforating the bone cortex of the pedicles. A navigation system is useful for cervical spine surgery because it enables a surgeon to perform relatively safe and accurate surgery during transpedicular screw fixation. However, attachment of the stereotactic reference arc to the spinous process is impossible, and the application of a navigation system is limited in cases in which laminectomy has been performed in the past. We have been using the pedicle axis view technique under fluoroscopy and have found that if we take care of the entry point accurately, we can safely insert the pedicle screw in cases with fewer landmarks.