经口咽前路寰枢椎复位钢板置入内固定治疗颅颈交界部畸形的MRI评价  

MRI evaluation of craniovertebral junction malformation with transoral atlantoaxial reduction plate internal fixation

作　　者：陈耿[1] 韩立新[1] 曹惠霞[1] 王俊[1] 赵玉翠[1] 莫树群[1] 

机构地区：[1]解放军广州军区总医院磁共振室,广东省广州市510010

出　　处：《中国组织工程研究与临床康复》2010年第48期9003-9006,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:颅颈交界部畸形经口咽前路寰枢椎复位钢板置入内固定治疗过程中,X射线、CT对于颅颈交界部病变的检查只能显示其骨性结构,无法显示脊髓情况。目的:分析颅颈交界部畸形经口咽前路寰枢椎复位钢板内固定前后的磁共振图像,探讨MRI成像对其内固定术式的选择及效果判断的价值。方法:选择2009-06/2010-04收治的颅颈交界部畸形患者25例,男9例,女16例,术前均行X射线、CT、MRI检查,采用经口咽前路寰枢椎复位钢板置入内固定治疗方式,置入后6个月内行MRI复查。结果与结论:所有患者均顺利完成内固定,未出现脊髓血管损伤等严重并发症。25例患者置入后MRI成像显示内固定在位,寰枢椎复位,脊髓受压情况改善,11例随访患者中,原上颈椎局部疼痛、活动受限等情况有9例明显改善或消失。提示MRI能够多方位清晰显示颅颈交界部畸形情况,对脊髓及颅内病变的显示更直接,可为颅颈交界部畸形经口咽前路寰枢椎复位钢板置入内固定手术方式的选择、脊髓受压情况及手术效果的判断、术后恢复提供客观依据。BACKGROUND：X-ray,CT examinations only show bone structure of craniocervical junction,but not the situation of spinal cord during craniovertebral junction malformation with transoral atlantoaxial reduction plate（TARP）internal fixation surgery.OBJECTIVE：To analyze the magnetic resonance images before and after craniovertebral junction malformation with TARP internal fixation,so as to evaluate the value of MRI in choosing surgical approach and judging effects of postoperative.METHODS：A total of 25 patients with craniovertebral junction malformation were selected from June 2009 to April 2010,comprising 9 males and 16 females.All patients underwent X ray,CT,and MRI examination.All patients were treated with TARP internal fixation surgery,and MRI examinations were performed in three months after surgery.RESULTS AND CONCLUSION：All patients completed surgery successfully,and did not appear serious complications such as spinal cord vascular injury.MR imaging in 25 patients showed postoperative fixation in site,skeletal of cranio-cervical junction reposition,compression of spinal cord improvement.In 11 cases which were followed up,the original partial upper cervical pain and limited mobility improved or disappeared in 9 cases.MRI can show deformity of craniocervical junction clearly in multi-dimensions,especially for spinal cord and cranio lesions;it may provide an objective basis for choice of surgery,judgment of compression condition of spinal cord and postoperative recovery.

关 键 词：颅颈交界部 畸形 磁共振 经口咽前路 内固定 医学植入物 

分 类 号：R318[医药卫生—生物医学工程]