Clinical application of lamina screw in thoracic internal fixation
ZHAO Yongjun1, BAI Chunhong1, TANG Jiqiang1, GONG Teng1, LI Zhonghai1, XIA Qun3, Chen Tingting2
1. Department of Orthopaedics; 2. Department of Emergency Medicine, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin 300162, China; 3. Department of Orthopedics, Tianjin First Central Hospital,Tianjin 300192, China
Abstract：Objective To investigate the clinical application of lamina screw in thoracic internal fixation.Methods A total of 8 thoracic spine disease patients (aged 37 to 59) who were treated with thoracic pedicle screws between April 2017 and June 2020 were prospectively included. The mean age was 43.2 years old. Of these participants, included 1 case of thoracic mycospondylitis, 1 case of thoracic Escherichia coli infection, 2 cases of thoracic facture revision, 2 cases of cervical fracture CT performed cervicothoracic fixation, and 2 cases of intraoperative pediclerupture were treated with lamina screw. All operations were performed under general anesthesia. Postoperative thoracic vertebral CT was performed to observe screw fixation, and at 3, 6, and 12 months after surgery, thoracic spine CT was reviewed to observe whether screws were loosenedorshifted. Thoracic Cobb angle, the VAS pain score and oswesty disability index (ODI) were measured preoperatively and postoperative 3, 6, and 12 months.Results There were 8 patients (32 laminar screws) followed with mean follow-up of (14.3±2.3) months. All screws were not loosened, pullout or fractured. At final follow-up, there was no statistically significant change in Cobb angle. The postoperative ODI (20.3%±1.2%) was significantly (t=28.8,P<0.01) lower than that before operation (79.9%±1.7%). The VAS pain score at 12 months after surgery (0.8±0.2) was significantly (t=12.3, P<0.01) lower than that before surgery (6.7±0.4).Conclusions In cases where thoracic pedicle screws cannot be placed, laminar screws are used to fix the spine with equal firmness.
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2021, Vol. 32 
