后路钉棒复位内固定技术在合并寰枕融合的寰枢椎脱位治疗中的应用  

POSTERIOR SCREW AND ROD INSTRUMENT FOR THE TREATMENT OF ATLANTOAXIAL DISLOCATION WITH OCCIPITALIZATION

作　　者：张挺 王飞 廖毓芝 袁磊 王兆伟 潘虹 张保中 Zhang Ting Wang Fei Liao Yu Zhi et al(Department of Neurosur gery , The general hospital of the PLA rocket force, Beijing 100088, China)

机构地区：[1]火箭军总医院神经外科,北京市100088

出　　处：《中国煤炭工业医学杂志》2017年第9期1043-1045,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨后路钉棒复位内固定技术在治疗合并寰枕融合的寰枢椎脱位的可行性及临床效果。方法回顾性统计23例2012年1月—2016年8月间火箭军总医院收治的合并寰枕融合的寰枢椎脱位患者的临床资料。其中男12例,女11例,年龄21~62岁。其中4例采用寰枢侧块螺钉棒系统行寰枢复位内固定,19例采用枕颈钉-棒系统复位内固定,并取髂后上棘自体骨植骨融合。结果术中未发生血管及神经功能损伤,术后CT示19/23例达到了水平方向的完全复位,18/23例获得了垂直方向的完全复位。21例完成了5~16个月的随访,随访CT示所有患者均达到了骨性愈合,MR示脑干所受的压迫均得到了解除。术后JOA评分提高至了15.3,与术前的11.9相比有统计学意义。结论后路枕颈复位内固定技术及寰枢侧块复位内固定技术是治疗合并寰枕融合的寰枢椎脱位的有效且安全可行的方法。Objective To explorethe surgical feasibility and clinical results for the treatment of atlantoaxial dislocation with occipitalization by posterior screw and rod instrument.Methods Between January 2012 and May 2014,23 patients who had atlantoaxial dislocation with occipitalization were admitted to our our institution.C1-C2 reduction and fixation instrument was used in 4 patients,occipital-cervical fixation was used in other patients.Results No neurovascular injury occurred during surgery.Post-operative CT showed that complete horizontal reduction was obtained in 19/23,and complete vertical reduction was obtained in 18/23.Follow-up ranged from 5 to 16 month in 21 patients.The repeated three dimensional CT and MR image demonstrated that bony fusion and the decompression of the medulla oblongata were obtained in all patients.JOA scores improved significantly.Conclusion This Posterior screw and rod instrument is a promising technique for the treatment of atlantoaxial dislocation with occipitalization.

关 键 词：寰枢脱位 寰枕融合 复位 内固定 

分 类 号：R682[医药卫生—骨科学]