Patent RU-2697992-C1 (RU)
Title: Method of screw fixation of c1-c2 vertebras (versions)
Inventor: NEKRASOV MIKHAIL ALEKSEEVICH
IPC: A61B17/56
Filed: 2018-10-12
Granted: 2019-08-21
Abstract: FIELD: medicine. 
     SUBSTANCE: group of inventions refers to medicine, particularly to surgery, and can be used for treating upper cervical vertebrae, particularly fixation of C1 and C2 vertebras in fractures. Method for helical fixation of C1-C2 vertebrae, in which, according to the first version, by neck extension by external apparatus, vertebral fragments C1 are compared, thereafter, at least one incision is performed on the neck surface; then, the correlated fragments C1 are connected to the C2 vertebra by means of at least one screw through the incision. Vertebral C1 elements to be joined are immovably rigidly fixed to each other with simultaneous support of C2 vertebral elements. Screw is a biodegradable screw. Biodegradable screw is selected so that motionless fixation from it between C1 and C2 vertebrae disappeared, on one side, after achieving the connection force between the elements C1 to be joined, in points of fractures of such a value that in the neck movements there was no breakage in the points of adhesion of the elements, on the other side, when there was no permanent connection of the contact articular surfaces C1 and C2 of the vertebrae. After formation of primary fusion of C1 fragments, the vertebra is simultaneously gradually beginning to perform rotational movements of C1 and C2 vertebrae relative to each other. Method for helical fixation of C1-C2 vertebrae, in which according to the second version, by neck extension by external apparatus, performing a comparison of a fragment of a tooth-like process of C2 vertebra with its body, performing at least one incision on the surface of neck, C1 and C2 vertebrae are connected through an incision with screws passing through roots of arcs C2 and further into lateral masses C1 of vertebra. Spliced portion of tooth-like process of body C2 is rigidly fixed to each other by mediated rigid fixation of C1 and C2 vertebrae with screws. Vertebral elements C1 are immovably fixed to each other with simultaneous support on C2 vertebral elements. Screw used is a biodegradable screw, the biodegradable screw is selected so that the immovably fixation from it between the C1 and C2 vertebrae disappeared, on one side, after achieving a force of connection between a fragment of a tooth-like process with a vertebral body C2, when it becomes sufficient to ensure that in neck motions there is no rupture in points of adhesion of elements, on the other side, when there is no permanent joint of contact articular surfaces of C1 and C2 vertebrae. After the primary fusion is formed, a fragment of a tooth-like process with a C2 vertebral body is simultaneously gradually started to perform rotational movements of C1 and C2 vertebrae relative to each other. 
     EFFECT: inventions provide fusion of vertebral elements with preservation of mobility C1 of vertebra (atlas) relative to C2 vertebra (axis), reduced traumatic risk of surgical intervention and facilitation of patient's postoperative and postoperative state. 
     6 cl, 40 dwg