合并复杂颅颈交界畸形的可复性寰枢椎脱位个性化治疗效果分析  

Personal treating strategy of reducible atlantoaxial dislocation associated with complicated craniocervical junction abnormalities

作　　者：梁峰[1] 刘瑞端[1] 姚强[1] 贾长青[1] 

机构地区：[1]中国医科大学附属盛京医院脊柱关节骨科,辽宁沈阳110006

出　　处：《生物医学工程与临床》2015年第2期140-143,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨合并复杂颅颈交界畸形的可复性寰枢椎脱位个性化治疗策略。方法收集2007年9月到2013年9月伴有颅颈交界区畸形的寰枢椎可复性脱位患者36例,其中男性21例,女性15例;年龄35~70岁,平均年龄45.6岁。均行后路减压、复位、植骨融合内固定术。随访时间4~38个月。结果平均手术时间2 h,平均出血量130 m L。术后临床症状得到不同程度的改善。35例患者获得随访,平均随访时间13个月。术前日本矫形外科学会（JOA）评分（9.0±1.5）分,术后3个月复查恢复至（15.6±0.8）分（P〈0.05）,末次随访为（15.8±0.6）分。术中发生椎动脉损伤1例,术后死亡。其余X射线片、CT复查示螺钉位置良好,术后复位满意,获骨性融合。结论对合并复杂颅颈交界畸形的可复性寰枢椎脱位,选择合适的治疗策略,对提高手术成功率至关重要。Objective To explore the personal treating strategy of reducible atlantoaxial dislocation associated with complicated craniocervical junction abnormalities. Methods From September 2007 to September 2013, 36 patients with reducible atlantoaxial dislocation associated with complicated craniocervical junction abnormalities were enrolled, which included 21 males and 15 females, aged 35- 70 years old with mean age of 45.6 years old. All of them were performed posterior decompression,reduction, bone graft fusion and internal fixation, and followed-up 4- 38 months. Results The average operation time was 2-hour and the average blood loss was 130 m L. The postoperative clinical symptoms were improved in different degree. Thirty-five cases were followed up, mean follow-up of 13 months. The Japanese Orthopedic Association（JOA） score before operation was 9.0 ±1.5, 3-month after operation was 15.6 ± 0.8（P〈0.05）, at the final follow-up, the JOA score was 15.8 ± 0.6. One case died postoperatively because of vertebral artery injury in operation, the other cases obtained satisfactory reduction and bone fusion were proved by X-ray and CT. Conclusion It is demonstrated that the appropriate treating strategy could improve the operation successful rate for the reducible atlantoaxial dislocation associated with complicated craniocervical junction patients.

关 键 词：颅颈交界畸形 可复性寰枢椎脱位 治疗方法 

分 类 号：R687.3[医药卫生—骨科学]