前路三钉内固定治疗寰椎-齿状突Ⅱ型骨折  

Triple anterior screw internal fixation in treating C_1-typeⅡodontoid fractures

作　　者：黄卫兵[1] 蔡贤华[1] 陈庄洪[1] 

机构地区：[1]广州军区武汉总医院骨科,武汉430070

出　　处：《中国骨与关节外科》2013年第6期487-490,共4页Chinese Journal of Bone and Joint Surgery

基　　金：全军医学科学技术研究"十一五"计划攻关课题(08G031);武汉市科技局科技攻关课题(201260523184)

摘　　要：背景：齿状突加寰枢椎前路经关节螺钉内固定是近来治疗寰椎-齿状突Ⅱ型骨折的一种新方法，临床报道较少。 目的：探讨颈前路三钉，即齿状突螺钉加寰枢椎前路经关节螺钉内固定治疗寰椎-齿状突Ⅱ型骨折的方法及疗效。 方法：2008年2月至2011年10月于C型臂X线机透视下行颈前路齿状突螺钉加寰枢椎经关节螺钉内固定治疗寰椎-齿状突Ⅱ型骨折5例。 结果：5例骨折患者共植入5枚齿状突螺钉，9枚经寰枢关节螺钉，1例因左侧经寰枢关节螺钉进钉点处骨折而行右侧单侧固定。全部获得随访，随访时间为10~30个月，平均18个月，螺钉位置满意，齿状突骨折均获骨性愈合，寰枢关节稳定，无一例发生螺钉松动、断钉，无一例发生脊髓、椎动脉损伤等并发症。 结论：颈前路齿状突螺钉加寰枢椎经关节螺钉内固定治疗寰椎-齿状突Ⅱ型骨折，对齿状突直接固定同时即刻稳定寰枢椎，为寰椎-齿状突Ⅱ型骨折患者提供了一种新的治疗方法。Background：Odontoid and bilateral transarticular C1-2 screw internal fixation is a new technique for treating the C1-typeⅡodontoid fractures. However, there were few clinical reports about it. 〈br〉 Objective：The purpose of the study is to investigate clinical outcomes of triple anterior screw internal fixation, namely the odontoid screw plus bilateral transarticular C1-2 screws, in treating C1-typeⅡodontoid fractures. 〈br〉 Methods：From February 2008 to October 2011, 5 patients with C1-typeⅡodontoid fractures received odontoid and bilater-al transarticular C1-2 screw internal fixation under the C-arm X-ray fluoroscopy. 〈br〉 Results：A total of 5 odontoid screws and 9 bilateral transarticular C1-2 screws were applied in the 5 patients. Because there was a fracture at the entrance point of the left-lateral transarticular C1-2 screw, one patient had to accept unilateral fixation on the right side. All patients were followed up. The follow-up period lasted for 10 to 30 months, with an average of 18 months. The screw positions were satisfactory. All the odontoid fractures obtained bony union, and atlanto-axial joints were stable. No rupture, loosening, damage of spinal cord or vertebral artery were observed. 〈br〉 Conclusions：Odontoid and bilateral transarticular C1-2 screws internal fixation can directly fix the odontoid as well as stabi-lize the atlanto-axial joints. It is a new technique for treating the C1-typeⅡodontoid fractures.

关 键 词：齿状突螺钉 寰枢关节 经关节螺钉内固定 寰枢椎联合骨折 

分 类 号：R687.3[医药卫生—骨科学]