颈后路椎弓根钉内固定植骨融合术治疗寰枢椎不稳定骨折  

Treatment of atlanto axial vertebral instability fractures with cervical posterior pedicle screw internal fixation and interbody fusion

作　　者：张志敏[1] 刘建[1] 张亚宁[1] 王宇飞[1] 黄春霞[1] 

机构地区：[1]临汾市人民医院脊柱外科,山西临汾041000

出　　处：《中国骨伤》2014年第9期762-765,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨颈后路椎弓根钉内固定植骨融合术治疗寰枢椎不稳定骨折的临床疗效。方法：2008年7月至2013年7月,采用颈后路寰枢椎椎弓根钉内固定植骨融合术治疗寰枢椎不稳定骨折患者21例,男14例,女7例;年龄20-55岁,平均32岁。术中利用寰枢椎椎弓根钉的提拉及牵引作用对移位的寰枢椎进行复位。结果：21例患者均获随访,时间6-24个月,平均12.5个月。伤口均愈合,无感染等并发症,术前患者均有不同程度四肢症状,术后6个月21例患者临床症状均缓解。术后6个月,ASIA评分的运动、轻触及针刺评分分别是99.45±0.27、111.09±0.47、111.11±0.58,较术前明显提高（P〈0.05）;VAS及NDI评分分别为1.04±0.38、12.56±2.24,均较术前明显提高（P〈0.05）;影像学检查示内固定位置好,未见寰枢关节不稳。结论：颈后路椎弓根钉内固定植骨融合术可以有效恢复寰枢椎关节的稳定性,减少并发症,疗效满意。Objective：To explore the clinical effects of cervical posterior pedicle screw internal fixation and interbody fusion for the treatment of atlanto axial vertebral instability fractures. Methods：From July 2008 to July 2013,21 patients with atlanto axial vertebral instability fractures were treated with vertebral pedicle screw internal fixation and interbody fusion through posterior approach. There were 14 males and 7 females ,aged from 20 to 55 years old with an average of 32 years. Lifted and guided the atlanto axial vertebral pedicle screw to reduce atlanto axial vertebral displacement. Results：All patients were followed up from 6 to 24 months with an average of 12.5 months. Wounds got healed without complication of infection. Clinical symptoms were relieved at 6 months after operation. According to ASIA score standard to assess at 6 months after operation ,the items of motion,light touch and needle score had obviously improved,and respectively were 99.45±0.27,111.09±0.47,111.11± 0.58. VAS and NDI scores also had obviously improved,and respectively were 1.04±0.38 and 12.56±2.24. Imaging examinations showed internal fixation locations were good ,without atlanto axial joint instability. Conclusion：Cervical posterior pedicle screw internal fixation and interbody fusion can effectively restore the stability of atlanto axial joint,reduce complication and obtain satisfactory effects.

关 键 词：颈椎 寰椎 枢椎 骨折 脊柱损伤 

分 类 号：R529.2[医药卫生—内科学]