椎弓根钉棒系统不对称撑开治疗齿突合并单侧关节面压缩性骨折  

Transpediclar screw fixation system for treatment of odontoid process fracture complicated with unilateral articular surface fracture

作　　者：陈国富[1] 洪正华[1] 洪盾[1] 王章富[1] 陈海啸[1] 

机构地区：[1]台州医院骨科,浙江317000

出　　处：《脊柱外科杂志》2013年第5期257-260,共4页Journal of Spinal Surgery

摘　　要：目的探讨椎弓根钉棒系统不对称撑开治疗齿突合并单侧关节面压缩骨折的临床疗效。方法 2005年12月～2011年4月共治疗此类患者12例,2例为陈旧骨折,其余均为新鲜骨折。患者均有不同程度的颈枕区疼痛,活动受限,疼痛视觉模拟量表(visual analogue scale,VAS)评分平均6.3分。所有患者实施颈后路寰枢椎椎弓根钉棒系统固定,两侧不对称撑开,行自体髂骨植骨,根据手术前后临床及影像学检查评价手术疗效。结果所有患者均获得随访,随访8～22个月,平均11.2个月,术后未出现螺钉松动、断裂,钉棒移位。术中未出现椎动脉或脊髓损伤。术后VAS评分平均1.1分,冠状面CT重建示头颈部骨性力线恢复良好,斜颈矫正率达83%,6个月随访见寰枢椎达到骨性融合。结论椎弓根钉棒系统不对称撑开治疗齿突合并单侧关节面骨折是一种固定牢固、安全可靠的方法。Objective To explore the curative effect of transpedicular screw fixation system for treatment of odontoid process fracture complicated with unilateral articular surface fracture. Methods From december 2005 to April 2011, 12 cases were involved in the research, 2 cases were old fracture, 10 cases were fresh fracture. The preoperative average visual analogue scale（VAS） scores were 6.3. All the cases were fixed with atlantoaxial pedicle screw system by cervical posterior approach under generalanesthesia. Asymmetry of distraction, autologous iliac bone grafting. Curative effect was evaluated by pre and postoperative clinical and imaging examine. Results All cases were followd up for 8 to 22 months, with an average of 11.2 months. No vertebral artery or spinal injury occurred during operation. No screw loosening, breakage or shifting occurred after operation. The wryneck correction rate was 83%. The postoperative average VAS score was 1.1. Coronal plane CT showed that the atlantoaxiai anatomic relationship recovered well and bony fusion was obtained after 6 months. Conclusion Atlantoaxial pedicle screw fixation for the treatment of odontoid process fracture complicated with unilateral articular surface fracture is a firm, safe and reliable method.

关 键 词：寰椎 寰枢关节 脊柱骨折 骨折 压缩性 内固定器 

分 类 号：R683.2[医药卫生—骨科学]