术中三维导航技术辅助前路螺钉内固定治疗Ⅱ型齿状突骨折的临床疗效研究  

Efficacy of anterior screw fixation for type Ⅱ odontoid fracture assisted by intraoperative 3-dimension computer navigation system

作　　者：陶晓晖[1] 田伟[1] 刘波[1] TAO Xiaohui;TIAN Wei;LIU Bo(Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 4th Clinical Medical College of Peking University, Beijing 100035, China)

机构地区：[1]北京积水潭医院北京大学第四临床医学院脊柱外科,北京100035

出　　处：《中华骨与关节外科杂志》2018年第6期416-419,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:齿状突骨折是老年人群中最常见的颈椎骨折,目前,对于齿状突骨折尤其是Ⅱ型齿状突骨折的治疗仍存在较大争议,骨折愈合率及并发症差异较大。目的:探讨术中计算机三维导航辅助下前路螺钉内固定术对Ⅱ型齿状突骨折的治疗效果、安全性及准确性。方法:回顾性分析2010年1月至2017年8月收治的32例Ⅱ型齿状突骨折患者的临床资料,男21例,女11例,年龄21~65岁,平均(39.1±12.4)岁。车祸伤18例,坠落伤10例,击打伤4例,所有螺钉均在术中三维导航下置入。评估其有效性和安全性。结果:32例患者共置入螺钉32枚,未发生与螺钉植入相关的并发症,所有患者均获得随访,随访时间为3~16个月,平均(9.6±3.2)个月。29例患者获得骨性愈合,愈合率达90.6%,3例患者获得纤维愈合,无临床症状。结论:术中计算机三维导航辅助下前路螺钉内固定术治疗Ⅱ型齿状突骨折具有较高的安全性和准确性,骨折愈合良好,临床效果良好。Background： The odontoid fracture is the most common cervical fracture in the elderly population. At present,there is still controverse regarding the treatment of odontoid fractures, especially type II odontoid fractures. The healing rate and complications of this fracture are quite different. Objective： To summarize the clinical results of anterior cannulated odontoid screw fixation for the type II odontoid fracture assisted by navigation system. Methods： From January 2010 to August 2017, clinical data of 32 patients with type II odontoid fracture treated surgically in our hospital were reviewed. Among them there were 21 males and 11 females, aged from 21 to 56 years old, mean age（39.1±12.4） years old. All patients complained of neck pain and limited cervical movement due to traffic accident（18 patients）, falling（10 patients） and hit（4 patients）. All patients received the cannulated odontoid screw fixation assisted by the real-time navigation system. Results： No intraoperative vertebral artery injury or spinal cord injury were noted. All 32 patients followed up for an average of（9.6 ±3.2） months（range, 3-16 months）. 29 patients got bony union and 3 patients obtained fibrous healing. Cervical movement of patients recovered to normal function. Conclusions： The application of computer assisted navigation in anterior odontoid screw fixation improves the accuracy and safety of the operation, with good bone union and clinical effect.

关 键 词：齿状突骨折 治疗 计算机辅助 导航 

分 类 号：R687.3[医药卫生—骨科学]