寰枢椎椎弓根钉固定融合治疗寰枢椎失稳  

Atlantoaxial Pedicle Screw-rods Fixation in Atlantoaxial Instability

作　　者：左春光 张军[1] 王新虎[1] 刘继军[1] 王建顺[1] 

机构地区：[1]陕西省宝鸡市中心医院脊柱外科,陕西宝鸡721008

出　　处：《实用骨科杂志》2010年第11期804-806,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨经后路寰枢椎椎弓根钉固定融合技术治疗寰枢椎失稳的手术方法、疗效。方法采用后路寰枢椎椎弓根螺钉系统,固定、融合治疗32例寰枢椎失稳患者,术中在C型臂X线机辅助下行C1、C2置钉,复位固定,取自体髂骨行椎板间植骨。术后颈托固定3个月。结果 32例128枚螺钉成功置入,复位满意,术中未发生椎动脉和脊髓损伤。患者全部获327个月定期随访,螺钉位置良好,钉棒无松动、断裂,术后36个月均获植骨融合。术前JOA评分（8.6±2.8）分;术后3个月JOA评分（14.9±1.8）分,恢复率76%92%,平均83%。结论经后路寰枢椎椎弓根钉固定融合技术具有直视下置钉、短节段固定、固定牢靠、植骨融合率高等特点,有利于稳定寰枢关节及脊髓功能的恢复,是一种较为理想的治疗寰枢椎失稳的内固定术式。Objective To discuss the therapeutic effects of the atlantoaxial pedicle screw-rods fixation in treatment of atlantoaxial instability.Methods 32 cases were treated by atlantoaxial pedicle screw system fixation.The JOA score was 8.6±2.8,the patients were treated by reduction and internal fixation with trans-atlantoaxial pedicle screw-rod.The bone graft was fixated between posterior arch of atlas and lamina of axis by the lateral combination bended to posterior.Results 128 atlantoaxial pedicle screws were implanted in 32 patients.No patient had the injure of spinal cord,nerve root and vertebral artery.All patient took place in follow up visits,the follow-up period ranged from 3 to 27 months.All fusion bone were combinated after 3～6 months.The inter fixation wasn′t loosening and breaking.3 months after operation,the JOA score was 14.9±1.8,average improvement rate was 83%.Conclusion The atlantoaxial pedicle screw system fixation was an effective method to treat atlantoaxial instability,which had many advantages,such as providing rigid fixation,short segment fixation,safe and simple,high fusion rate.It is appropriate to reconstruct the stability of upper cervix.

关 键 词：寰枢椎 椎弓根螺钉 内固定 

分 类 号：R681.55[医药卫生—骨科学]