C_2下关节突螺钉联合C_1侧块螺钉钛棒固定技术在寰枢椎脱位治疗中的应用  

C_2 trans-inferior articular process screw and C_1 lateral mass screw rod fixation for atlantoaxial dislocation

作　　者：宗睿[1] 尹一恒[1] 余新光[1] 乔广宇[1] 

机构地区：[1]中国人民解放军总医院神经外科,北京100853

出　　处：《临床神经外科杂志》2016年第3期165-168,共4页Journal of Clinical Neurosurgery

摘　　要：目的探讨C_2下关节突螺钉的手术技术和临床经验。方法回顾性分析20例用C_2下关节螺钉代替C_2椎弓根螺钉与C_1侧块螺钉连棒固定患者的临床资料。对其术后影像及临床JOA评分进行评估。结果共植入23枚下关节突螺钉(3例双侧,17例单侧),除4枚突入椎间孔外口(小于1 mm),其他均准确植入。突入椎间孔螺钉未引起相关神经根性疼痛。患者术后JOA评分从术前的平均12.2分提高到术后的15.4分。枕颈植骨融合率为100%。结论对不适合C_2椎弓根螺钉的患者,C_2下关节突螺钉可以做为一个替代的选择。Objective To present our experiences and clinical results with C2 trans-inferior articular process screw （C2IAPS） fixation technique. Methods The clinical data of 20 patients with atlantoaxial dislocation, which were treated with C2IAPS and C1 lateral mass screw （C1LMS） rod fixation were analyzed retrospectively. All patients were clinically assessed by JOA score and postoperative imaging. Results A total of 23 C2IAPS were implanted （3 cases were bilateral, and 17 cases were unilateral implanted）. Except for 4 C2IAPS were real-implanted into the external ostium of the intervertebral foramen, all CzIAPS were accurately inserted. There was no screw related neuralgia. The average JOA score improve 12.2 preoperatively to 15.4 postoperatively. Rigid bony fusion was demonstrated in all patients （ 100% ）. Conclusion C2IAPS can be used as an alternative choice for patients who were not available for C2 pedicle screw.

关 键 词：C2下关节突螺钉 C1侧块螺钉 钉棒固定 寰枢椎脱位 颅颈交界畸形 

分 类 号：R826.65[医药卫生—临床医学]