Apofix与Simmons在治疗寰枢椎脱位并脊髓不全损伤中的对照研究  

The Comparative Study Between Apofix and Simmons for Treatment of Atlantoaxial Dislocation with Incomplete Spinal Cord Injury

作　　者：贺宝荣[1] 郝定均[1] 雷伟[2] 王臻[2] 孙宏慧[3] 宋宗让[1] 窦榆生[1] 

机构地区：[1]西安市红十字会医院脊柱外科,710054 [2]第四军医大学西京医院骨科,710032 [3]第四军医大学唐都医院骨科,710038

出　　处：《美中国际创伤杂志》2008年第1期48-49,32,共3页U.S.Chinese International Journal of Traumatology

摘　　要：目的：回顾性分析Apifix与Simmons方法在寰枢椎脱位并脊髓不全损伤，寰枢椎融合内固定中的应用价值。方法：61例陈旧性寰枢椎脱位并脊髓不全损伤行减压，后路融合、Apifix或Simmons内固定，Apifix29例，Simmons32例。男36例，女25例，年龄11—65岁，平均35．9岁。寰枢椎脱位23例，新鲜齿状突骨折11例，陈旧性齿状突骨折9例，先天性脱位5例，创伤性寰椎横韧带断裂8例，单侧椎弓骨折3例，一侧关节脱位2例。结果：Simmons组椎体移位1例，植骨未融合2例，钢丝断裂2例。术后脊髓功能JOA改善率两者无差异。结论：Simmons对旋转和侧移位控制能力差，无法控制平移；Apofix与之相比有独特的优点。Objective： To analyze the curative effect of Apofix and Simmons for treatment of atlantoaxial dislocation with incomplete spinal cord injury. Methods： 61 cases of timeworn atlantoaxial dislocation with incomplete spinal cord injury, 36 male and 25 female, aged from 11 to 65 years with an average age of 35.9 years, were employed in this study group. Among those cases, there are 23 cases of atlantoaxial dislocation, 11 cases of fresh odontoid process fracture, 9 cases of timeworn odontoid process fracture, 5 cases of congenital dislocation, 8 cases of traumatic interruption of ligament transversum atlantis, 3 cases of unilateral vertebral arch fracture, and 2 cases of unilateral articular dislocation. All the patients were treated by decompression, posterior fusion and internal fixation with Apofix（29 cases） or Simmons（32 cases）. Results： There was no difference in improvement of JOA scores between two groups. However, the complications in Simmons group included vertebral body displacement in 1 case, nonunion of bone graft in 2 cases and breakage of wire in 2 cases. Conclusion： Simmons system has a poor controllability in rotation and lateral displacement, and can＇t control parallel displacement. Inversely, Apofix system has this advantage.

关 键 词：寰枢椎脱位 寰枢融合 内固定 对照研究 

分 类 号：R681.5[医药卫生—骨科学]