Clinical application of Orion and Zephir locking anterior cervical spine plates in cervical spine surgery Compression, bone graft fusion, Orion or Zephir internal fixation. Results: One of the 13 cases died of respiratory failure on the 10th day after cervical fracture and dislocation. The remaining 12 cases were followed up for an average of 8.6 months or more. Except for 3 patients with Frankel grade A spinal cord injury who did not recover from paraplegia, the remaining patients recovered to varying degrees after operation. The bone graft healed at 3 months without any complications such as plate fracture and screw loosening. Conclusion: Orion and Zephir steel plates are easy to operate, can provide effective stability of fixed segments, and are conducive to healing of bone grafts. It has important clinical value for the treatment of cervical trauma, degenerative changes and vertebral body tumors. Since the cervical spine anterior plate has been reported in China since 1996, it has been used in cervical degenerative diseases and cervical vertebral body tumors. The anterior cervical locking plate provides effective fixation for bone graft, and the fusion rate of bone graft is significantly improved. From 1998 to 2001 in our hospital, 13 cases of Orion and Zeph locking cervical spine plate system were used in the operation of the cervical spondyloid LI path. The results and results were satisfactory. Materials and methods 1. General data 13 cases in this group, 11 males and 2 females, Age 1> 42 years, average 33.6 years, including 2 cases of cervical spondylotic myelopathy, 1 case of cervical spine tumor, 10 cases of cervical vertebral body fracture, dislocation with paraplegia (Frankel grade 4 cases. Grade B 3 cases, grade C 3 cases) fusion Segments: 3 cases of single segment, 10 cases of double segment, the highest segment is G, the lowest segment C7 uses Orion plate 11 cases, 2 cases of Zephir plate 1 internal fixation material meter used by SofamorDanek company Oon and Zeph cervical spine The front locking type pure titanium steel plate O-plate is designed with a diagonally recessed slot that is used to fix the bone graft screw into any suitable position. The screw has a cancellous bone fixation screw, diameter 4mm, length 10 ~ 24mm; center The cortical bone fixation screw and the locking screw are 2 mm long. The locking screw is located between the two fixing screw holes, and the two fixing screws can be locked with one locking screw. The thickness of the Zephir steel plate is only 1.6 mm, and the maximum amaranth degree is only 15 mm. The small size can reduce the possibility of esophageal irritation and minimize the exposure size of the surgical incision. Its locking device is designed as a stopper to ensure the safety and fixation of the internal fixation structure. The screw hole of the bone graft passes through the eccentric screw hole, so that relative movement between the screw and the steel plate can be achieved to achieve the three surgical methods of pressurizing the bone graft and postoperative treatment of the patient in the supine position, the shoulder and back are raised, and the head is extended later. Perform local anesthesia with 1% lidocaine or general anesthesia with endotracheal intubation, routinely lay sterile towels, and make a 4-5 cm long transverse incision on the front right side of the neck to reveal the diseased vertebral body or segment and its adjacent upper and lower sides A vertebral body.

The length of Li steel plate is 25 ~ 90mm, Amaranth 18 Li. Thick two-legged, steel fracture cases are treated by subtotal vertebral body resection for the compression of the vertebral body of the spinal cord, two adjacent intervertebral discs and cartilage plates; Resection of the diseased intervertebral disc and the lower 1/3 of the upper vertebral body and 1 to 3 of the lower vertebral body with a circular saw method. If two adjacent discs protrude, the grooved decompression method is used to remove the disc tissue and the middle part of the intervertebral body. After decompression, the range grows into a trough, and vertebral tumors should be completely decompressed based on the principle of resection as much as possible, and hemostasis should be taken completely. The locking steel plate is placed in front of the vertebrae. Make sure that the plate is centered. Drill holes diagonally on the upper and lower ends of the plate and tap. Each screw a cancellous bone fixation screw. The angle of the screw is toward the head and the tail. At a 15 * angle, insert another diagonal cancellous screw, and then screw the two locking screws between the upper and lower pairs of cancellous bone screws to lock the final groove on the surface of Orion steel plate or Zephir steel plate. Dispose of a suitable screw hole to fix a bone graft block with a fixing screw set. In order to ensure the accuracy of the internal fixation position, C-arm X-ray TV monitoring is routinely used during the operation.

There is no need for strict bed rest after surgery. The wound is built with half-pipe or hose drainage. After drainage is removed 24 hours after surgery, the patient can sit up and move. Patients without spinal cord injury can move out of bed under the protection of the cervical collar. Routine application of antibiotics and hormones are 3 to 5 days. Take a photo of the cervical spine front and side around 1w to understand the position of the inner plant. Three months after the operation, the X-ray film was reviewed to understand the healing of the bone graft.

Respiratory failure occurred on the 2nd postoperative day and died on the 10th postoperative day. The rest were followed up for more than half a year, with an average follow-up time of 8.6 months. The results: 3 cases of cervical vertebral body fracture, dislocation with paraplegia, Frankel A grade, no postoperative symptoms Improvement, 3 cases of B grade improved to 1 case of C grade, 2 cases of D grade; 3 cases of C grade, all improved to 2 cases of cervical spondylosis and 1 case of cervical tumor, postoperative muscle tone decreased, and nervous system function recovered . All the bone grafts achieved bone healing 3 months after the operation, and none of them had complications such as plate fracture, screw loosening, and shedding.

1. The significance of locking plate in anterior cervical decompression and fusion surgery. Currently, anterior cervical decompression and bone graft fusion has been widely used in cervical spine injury and disease. For cervical fracture and dislocation, its fracture fragments protrude into the spinal canal, or vertebral body. Direct compression of the spinal cord, osteosarcoma of the posterior vertebral body caused by cervical spine degeneration, intervertebral disc herniation or destruction of vertebral body tumors compresses the spinal cord. Anterior cervical surgery can completely decompress and relieve the compression. All autogenous iliac bone graft fusions should be resected after resection of the diseased segment. Due to the insufficient stability of the bone graft interface, the bone graft is delayed to heal, and even pseudo-arthrosis is formed. It has been reported that pseudo-arthrodesis occurs after anterior cervical decompression and bone graft fusion Locking anterior cervical plate with a rate of up to 2% can provide fixation on the basis of anterior decompression, which significantly improves stability and is beneficial to patients' early activities and bone graft fusion.

Indications for anterior cervical locking plate are currently recognized as vertebral fractures, vertebral body tumor compression spinal cord decompression, and the use of anterior locking cervical plate to achieve immediate stability after tumor removal, even for cervical spine, fracture dislocation and complete paraplegia Patients are also helpful for patients to do active exercises and rehabilitation care in bed, which is helpful to reduce paraplegic complications and to strengthen patients' confidence in rehabilitation. Even complete dislocation of severe lower cervical spine fractures and dislocations is also an indication for this operation, but it is degenerative to the cervical spine. Diseases such as cervical spondylosis are treated surgically. Because anterior cervical spine surgery does not require internal fixation and can leave the bed early, there is a big controversy about the internal fixation of cervical spondylosis. There are only 2 cases of cervical spondylotic myelopathy in this group, and follow-up The short-term long-term complications need to be observed and re-evaluated.

The advantages of the three-locked steel plate are that Orion and Zeph steel plates are designed with fixing devices to reduce screw loosening, prolapse and other complications. As long as the appropriate length of the steel plate is applied, the upper and lower cancellous bone screws are just fixed to the middle of the upper and lower vertebral body of the bone graft, so that Plates, screws, vertebral bodies and bone grafts are firmly connected into a whole, so that the fixed segment is internally stable. Therefore, the patient does not need to be firmly fixed externally after surgery. The anterior cervical "H * type plate screw technology used in the 70s and 80s is conducive to rehabilitation. Since there is no locking device, the joint between the plate and the screw is easy to loosen. The screw thread on the top of the screw must penetrate the posterior margin of the vertebral body to achieve internal fixation. Reliable and firm, easy to damage the spinal cord. With the locking plate, the screw tip does not need to penetrate the cortical bone behind the vertebral body to achieve a reliable fixation effect. Therefore, surgical safety is added, and the risk of accidental injury to the spinal cord by the fixing screw is avoided. Orion and Zephir plate screws are all Made of pure titanium material, it has good biocompatibility and corrosion resistance, its strength and yield strength are good, so it can be avoided A second operation to remove the line of fixation, since the non-magnetic material is titanium, the spinal cord does not affect the image, so after determining the cervical spinal cord health still acceptable MRI.

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