寰椎后弓椎板钩联合枢椎椎弓根螺钉治疗寰枢椎脱位的临床研究  

Clinical investigation of laminar hook of atlas posterior arch combined with axis pedicle screw in the treatment of atlantoaxial dislocation

作　　者：付兆宗[1] 陈忠羡[1] 梁胜根[1] 赵振东[1] 付朝华[1] 雷洪俊[1] 刘一涛[1] 

机构地区：[1]广东省江门市中心医院脊柱外科,529030

出　　处：《蚌埠医学院学报》2017年第5期622-625,共4页Journal of Bengbu Medical College

基　　金：广东省自然科学基金项目(2015A030310248)

摘　　要：目的:探讨寰椎后弓椎板钩联合枢椎椎弓根螺钉内固定治疗寰枢椎脱位的临床疗效及安全性。方法:选择寰枢椎脱位病人12例,接受后路枢椎椎弓根螺钉联合寰椎椎板钩固定术。术后随访,采用日本骨科协会评估治疗评分评估神经功能的恢复情况,视觉模拟评分法评分评估疼痛症状,CT检查评估融合情况。结果:术后病人颈部疼痛评分显著降低(P<0.01),日本骨科协会评估治疗评分显著提高(P<0.01)。所有病人均未出现脊髓损伤、椎动脉损伤、术后感染等并发症。术后随访6个月内,固定节段融合良好。结论:寰枢椎钉钩系统治疗寰枢椎脱位是一种安全有效的手术方法。Objective：To investigate the clinical efficacy and safety of the laminar hook of atlas posterior arch combined with axis pedicle screw in the treatment of atlantoaxial dislocation.Methods：Twelve patients with atlantoaxial dislocation were treated with the laminar hook of atlas posterior arch combined with axis pedicle screw fixation.All cases were followed up.The pain and neurological function recovery of patients were evaluated using the visual analogue scale（VAS） and Japanese orthopaedic association scores（JOA） scoring,respectively.The atlantoaxial fusion was assessed using CT examination.Results：The VAS and JOA scores of the patients significantly decreased and increased after operations,respectively（P〈0.01）.No spinal cord injury,vertebral artery injury and infection in all cases were found.During the 6 months of following up,the atlantoaxial fusion in all cases were better.Conclusions：The treatment of atlantoaxial dislocation with laminar hook of atlas posterior arch combined with axis pedicle screw is an effective and safe operation method.

关 键 词：寰枢椎脱位 椎弓根螺钉 椎板钩 齿状突骨折 

分 类 号：R681.53[医药卫生—骨科学]