ISO-3D辅助计算机导航下齿突骨折的前路螺钉内固定治疗  

Anterior screw fixation for odontoid fracture by using ISO-3D computer assistant navigation

作　　者：张波[1] 田伟[1] 王永庆[1] 刘波[1] 李勤[1] 袁强[1] 

机构地区：[1]北京积水潭医院,北京100035

出　　处：《山东医药》2010年第28期24-26,F0003,共4页Shandong Medical Journal

摘　　要：目的探讨ISO-3D辅助计算机导航下前路螺钉内固定治疗齿突骨折的可行性和效果。方法外伤致齿突Ⅱ型骨折和浅Ⅲ型骨折齿突骨折患者27例,在全麻下行ISO-3D辅助计算机导航下前路螺钉内固定。考察围手术期情况及1 a复查状况。结果所有患者均顺利完成手术,无并发症发生。手术时间70～180 min、平均110 min,出血量30～100 ml、平均56 ml。切口均一期愈合,无感染或延迟愈合发生。术后1 a复查,24例骨折愈合,3例骨折线仍存在,上颈椎无不稳定发生。螺钉固定稳定,无折断、松动、脱出或骨质内豁出等内固定失败发生。颈椎左右旋转40°～70°、平均51°。无相应神经症状出现或加重。结论 ISO-3D辅助计算机导航下齿突骨折的前路螺钉内固定提高了手术的精确度和安全性,减少了放射暴露剂量,手术时间并未显著延长,应用优势明显。Objective To investigate the feasibility and results of anterior odontoid screw fixation by using ISO-3D computer assistant navigation.Methods There were 27 patients with type Ⅱ or shallow type Ⅲ dens fracture underwent anterior odontoid screw fixation assisted by using ISO-3D computer assistant navigation.The patients＇ clinical outcomes within-and after-operation were evaluated.Results All patients underwent the operation successfully with no complication occurred.The operation time was 70 to 180 minutes,with an average of 110 minutes.The blood-losing was 30 to 100 ml,with an average of 56 ml.The cut healed by first intention and no infection occurred.On 1-year-follow-up,bony union was observed in 24 patients meanwhile fracture line was still visible in 3 patients.The screw fixation remains stable and no upper cervical unstable or inner-fixation failure occurred.The neck degree in rotation on each side was 40° to 70°,with an average of 51°.No related neural symptom occurred or worsen.Conclusion The application of ISO-3D computer assistant navigation in anterior odontoid screw fixation improve the accuracy and security of the operation,decrease the radiological dose on operator and did not increase the operation-time significantly,which indicates a better advantage.

关 键 词：外科手术 计算机辅助 齿突 脊柱骨折 内固定器 

分 类 号：R683.2[医药卫生—骨科学]