蝶形枕颈内固定系统在低龄儿童上颈椎手术的初步应用  

Preliminary application of butterfly-style occipitocervical fixation system in upper cervical spine surgery for underage children

作　　者：王建华[1] 张东升[1] 郑勇强[2] 廖穗祥[3] 夏虹[1] 尹庆水[1] WANG Jianhua;ZHANG Dongsheng;XIA Hong;YIN Qingshui;ZHENG Yongqiang;LIAO Suixiang,(Department of Spinal Surgery, Guangzhou General Hospital of Guangzhou Military Command, Institute of Traumatic Orthopaedics of PLA, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Guangzhou, Guangdong 510010, China.)

机构地区：[1]广州军区广州总医院脊柱外科全军创伤骨科研究所全军热区创伤救治与组织修复重点实验室,510010 [2]晋江市医院骨一科,福建362200 [3]番禺区人民医院骨科,广东广州511400

出　　处：《中国骨科临床与基础研究杂志》2016年第3期141-145,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：广东省科技计划项目(2013B021800057);广东省科技计划项目(2014A040401060);广州市科技计划项目(1561000281)

摘　　要：目的研制可用于低龄儿童上颈椎手术的蝶形枕颈内固定系统,并探讨其初步应用效果。方法设计1套符合儿童解剖学特点、低切迹多锚点的枕颈内固定装置,观察1例幼儿应用该枕颈内固定系统的临床效果。结果成功研制由蝶形枕骨板、椎弓根螺钉和3.5 mm钛棒组成的蝶形枕颈内固定系统;将该系统用于1例2岁寰枢椎脱位患儿,术后寰枢椎脱位复位满意,脊髓压迫解除,内固定在位良好,术后随访1年,随访期间脊髓功能明显改善,恢复正常行走。结论新型蝶形枕颈内固定系统有效增强了枕骨固定强度,可用于低龄儿童上颈椎手术。Objective To develop a butterfly-style occipitocervical fixation system applied in upper cervicalspine surgery for underage children, and to explore its preliminary applicable effect. Methods A set ofoccipitocervical fixation device with low-profiles and multi-anchor points was designed according to pediatricanatomic characteristics, and the clinical effect was observed in one child applied with the system. Results Beingconsisted of butterfly-style occipital plate, pedicle screws and titanium rod (3.5 mm), butterfly-styleoccipitocervical fixation system was developed successfully. The system was applied for a 2-year-old child withatlantoaxial dislocation. Postoperative results showed that atlantoaxial reduction was obtained, spinal cord compression was relieved and fixation placement position was satisfactory. The patient was followed-up for 1year, during the follow-up, spinal function was improved significanly, and normal walking function was restored.Conclusion Novel butterfly-style occipitocervical fixation system could improve the occipital fixation rigidity,and is suitable for underage children who have to receive upper cervical spine surgery.

关 键 词：颈椎 寰枢关节 脱位 枕颈固定 内固定器 骨板 骨螺丝 钛 儿童 

分 类 号：R726.8[医药卫生—儿科]