难复型寰枢椎脱位的手术治疗  

Surgical Treatment in Unreducible Atlantoaxial Dislocation

作　　者：杨利民[1] 任跃兵[1] 张承韶[1] 胡海升[1] 林勇[1] 

机构地区：[1]青岛市市立医院东院骨科,青岛266071

出　　处：《中国现代手术学杂志》2010年第4期266-269,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨后路寰枢椎弓根钉棒系统在难复型寰枢椎脱位的临床应用。方法 18例难复型寰枢椎脱位患者,采用后路寰枢椎弓根钉棒系统,进行寰枢椎部分撑开后提拉复位,固定及植骨融合,其中单纯固定融合14例,加行颈椎管成压术者4例。结果本组平均手术时间2.8(1.8～3.6)h,平均出血量380(150～680)ml,均无术中、术后并发症,无脊髓损伤症状加重。18例患者获得6月～3年随访,获得良好寰枢椎骨性融合,钉棒系统内固定牢固,无松动;寰枢椎保持复位位置;术后脊髓功能(JOA17分法)改善率82.3%,其中优12例,良4例,有效2例。结论经后路寰枢椎弓根钉棒系统,对寰枢椎进行部分撑开后提拉复位,一次完成难复型寰枢椎脱位的复位、固定和融合,是治疗难复型寰枢椎脱位较理想的手术方法。Objective To analyze the post atlantoaxial pedicle screws systems in the treatment of unreducible atlantoaxial dislocation.Methods 18 cases of unreducible atlantoaxial dislocation from September 2004 to June 2009 were surgically treated by post atlantoaxial pedicle screws systems.The atlantoaxial vertebra were partly disjoined,lifted and fixed,including simple immobilization in 14 cases and combined with cervical spinal canal decompression in 4 cases.Results The mean operative time was 2.8（1.8～3.6）hours,and the mean blood loss was 380（150～680）ml.All the cases were followed up for six months to three years.All patients got completed fusion and atlantoaxial reduction in good position.There was no intraoperative and postoperative complication,nor deterioration of neuron-function,fixation break or displacement.The improved rate of JOA scores was 82.3%.Conclusion The post atlantoaxial pedicle screws fixation system,may be used to achieve the diaplasis and fixation and fusion of unreducible atlantoaxial dislocation simultaneously,is an effective method for treating the unreducible atlantoaxial dislocation.

关 键 词：寰枢椎脱位 内固定器 

分 类 号：R687.3[医药卫生—骨科学]