经口单开门小钛板复位固定治疗寰椎前后弓骨折  

Transoral reduction and fixation of anterior-posterior arch fractures of C_1 with open-door mini titanium plate

作　　者：马向阳[1] 杨进城[1] 邹小宝[1] 王宾宾[1] 杨浩志 MA Xiang-yang;YANG Jin-cheng;ZOU Xiao-bao;WANG Bin-bin;YANG Hao-zhi(Department of Spinal Surgery,General Hospital of Guangzhou Military Command of PLA,Guangzhou 510010,Guangdong,China)

机构地区：[1]广州军区广州总医院脊柱外科,广东510010

出　　处：《脊柱外科杂志》2018年第2期66-70,共5页Journal of Spinal Surgery

基　　金：广东省省级科技计划项目(2015B020233013);广州市科技计划项目(2014Y2-00168;201803010046)

摘　　要：目的探讨利用单开门小钛板经口复位固定治疗寰椎前后弓骨折的临床疗效。方法 2012年11月—2015年11月,应用经口单开门小钛板复位固定术治疗寰椎前后弓骨折患者13例,其中寰椎前弓1处骨折合并后弓1处骨折6例,寰椎前弓2处骨折合并后弓1处骨折3例,寰椎前弓1处骨折合并后弓2处骨折和寰椎前弓2处骨折合并后弓2处骨折各2例。记录手术前后美国脊髓损伤协会(ASIA)分级及视觉模拟量表(VAS)评分,术后定期随访复查X线片、CT以评价寰椎骨折复位、骨折愈合和内固定情况以及寰枢椎的稳定性。结果 13例患者均顺利完成手术,术中未发生脊髓及椎动脉损伤。术前ASIA分级D级2例,E级11例,术后均为E级;VAS评分由术前的(6.2±1.8)分降低至术后的(2.0±0.8)分。随访3~24个月,X线片、CT复查示小钛板固定良好、无松动,骨折均获骨性愈合,无寰枢椎失稳、脱位发生。结论经口单开门小钛板复位固定是治疗寰椎前后弓骨折的有效方法,初步临床应用效果满意。Objective To evaluate the outcome of transoral reduction and fixation of anterior-posterior arch fracture of atlas with an open-door mini titanium plate.Methods From November 2012 to November 2015,13 patients with anterior-posterior arch fracture of atlas,including 6 with 1 fracture at anterior arch and 1 fracture at posterior arch,3 with 2 fractures at anterior arch and 1 fracture at posterior arch,2 with 1 fracture at anterior arch and 2 fractures at posterior arch,2 with 2 fractures at anterior arch and 2 fractures at posterior arch,were treated with transoral open-door mini titanium plate reduction fixation.The American Spinal Cord Injury Association(ASIA)grades and visual analogue scale(VAS)score were recorded before and after operation.Patients were followed up and underweat roentgenograph and CT examination to estimate reduction,fixation,union of fracture and the stability of atlantoaxial segment.Results All the operations were successfully performed without neurovascular injury.ASIA grade was D in 2 cases and E in 11 cases before treatment,and after operation,ASIA grade was E in all patients.VAS score reduced from preoperative(6.2±1.8)to(2.0±0.8)after operation.The patients were followed up for 3-24 months.Solid bony union of fracture and no instrument displacement was found on roentgenograph and CT.No atlantoaxial instability or dislocation occurred.Conclusion Transoral reduction and fixation procedure with open-door mini titanium plate is an effective surgical method for treatment of anterior-posterior arch fracture of atlas with an ideal preliminary clinical effect.

关 键 词：寰椎 脊柱骨折 内固定器 

分 类 号：R683.2[医药卫生—骨科学]