寰枢椎翻修手术的原因分析及治疗对策  

Causes and therapeutic strategy of atlantoaxial revision

作　　者：王永福[1] 张宏其[1] 陈凌强[1] 吴建煌[1] 刘金洋[1] 刘少华[1] 赵迪[1] 

机构地区：[1]中南大学湘雅医院脊柱外科,湖南410008

出　　处：《脊柱外科杂志》2010年第3期140-143,共4页Journal of Spinal Surgery

摘　　要：目的分析寰枢椎翻修手术的原因,并探讨其治疗对策。方法回顾性研究2004年1月～2009年4月收治的13例寰枢椎手术失败病例,分析手术失败的原因,并分别予以不同的翻修治疗方案,观察其疗效。结果全部患者翻修手术均安全完成,无脊髓及血管损伤及其他严重并发症。平均随访24个月,所有病例寰枢椎均获骨性融合,患者症状明显改善,神经功能基本恢复。结论寰枢椎手术失败的主要原因是手术方式不恰当,导致内固定失败、植骨不融合及脊髓压迫;对部分复位者,C2椎弓根螺钉有助于进一步复位,避免了再次前路手术。Objective To discuss the causes of atlantoaxial revision and to explore relevant prevention and therapeutic strategy.Methods From January 2004 to April 2009,13 patients with surgical failure who underwent atlantoaxial revision were studied retrospectively.Reasons for failure of atlantoaxial operation were analyzed.Different revisions were performed and curative effects were evaluated.Results All the patients underwent atlantoaxial revisions successfully without any neurological deficit or vascular injury.No severe complications were noticed.The average follow-up was 24 months.After revision,bone fusion of atlantoaxial was obtained in all the cases and symptoms were improved obviously,and extremity numbness and weakness disappeared.Conclusion Nonunion,incomplete decompression and failure of internal fixation due to improper surgical choice are the main causes that lead to atlantoaxial revision.For partial reduction cases of atlantoaxial dislocation,C2 pedicle screws are helpful to further reduction that another anterior surgery may be avoided.

关 键 词：寰椎 枢椎 脊柱融合术 减压术 外科 内固定器 

分 类 号：R681.531[医药卫生—骨科学]