单纯经后路手术治疗先天性颅底陷入症合并的寰枢椎脱位  

Single - stage posterior approach for the treatment of congenital basilar invagination with atlantoaxial dislocation

作　　者：韩圣[1] 邹敬宇[1] 刘源[1] 程鹏[1] 秦晓飞[1] 吴安华[1] 

机构地区：[1]中国医科大学附属第一医院神经外科,沈阳110001

出　　处：《中华神经外科杂志》2013年第9期892-895,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨单纯经后路手术治疗先天陛颅底陷入症合并寰枢椎脱位的效果。方法2008年4月至2012年2月，对25例先天性颅底陷入症合并寰枢椎脱位患者，采用单纯经后路手术，术中行C2椎弓根和C1侧块或枕骨螺钉内固定及螺钉问撑开技术，对手术效果进行分析总结。结果所有患者术前术后均未行经口齿状突切除。随访6—40个月，无患者出现症状恶化，22例患者症状有不同程度改善。术后影像学检查显示，所有患者均复位满意，减压充分，24例患者形成良好骨性融合。结论单纯后路复位及固定结合术中螺钉问撑开技术，可以安全有效地治疗先天性颅底陷入症。Objective To evaluate the effectiveness and clinical outcome of a single - stage posterior reduction and fixation using intraoperative distraction between the occiput or Cl lateral mass and the C2 pedicle screws for patients with congenital basilar invagination. Methods 25 patients with congenital basilar invagination that underwent a single - stage posterior approach from April 2008 to February 2012 were reviewed. The surgical technique and treatment procedures were intensively analyzed. The clinical assessment and measurements of the images were performed pre - and postoperatively. Results Follow - up ranged from 6 to 40 months. No patient suffered postoperative deterioration; clinical symptoms improved in 22 patients and remained stable in 3 patients. Postoperative images showed that, satisfactory decompression and complete or more than 50% reduction were achieved in all 25 patients. Bone fusion was confirmed in 24 patients and 1 patient is still under follow - up. Conclusion The single - stage posterior reduction and fixation method, using the intraoperative distraction technique, is effective and secure for the treatment of congenital basilar invagination with atlantoaxial dislocation.

关 键 词：后路固定 颅底陷入症 寰枢椎脱位 

分 类 号：R651.1[医药卫生—外科学]