解剖型顶棒辅助后路C_(2)椎弓根钉内固定治疗寰枢椎不稳对咽后壁软组织的影响  

Effect of anatomic bucking bar assisted posterior C_(2) pedicle screw internal fixation on soft tissue of posterior pharyngeal wall in treatment of atlantoaxial instability

作　　者：周虹羽 汪姝玥 王清 徐双 王高举 ZHOU Hong-yu;WANG Shu-yue;WANG Qing;XU Shuang;WANG Gao-ju(Department of Orthopedics,Affiliated Hospital of Panzhihua University,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花学院附属医院骨科,四川攀枝花617000 [2]西南医科大学附属医院脊柱外科,四川泸州646000

出　　处：《中国骨与关节损伤杂志》2022年第3期246-249,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的分析解剖型顶棒辅助后路C_(2)椎弓根钉内固定治疗寰枢椎不稳对咽后壁软组织的影响。方法回顾性分析自2015-08—2017-12采用解剖型顶棒辅助后路C_(2)椎弓根钉内固定治疗的31例寰枢椎不稳,记录随访期间咽后壁黏膜损伤与软组织增厚情况,记录黏膜损伤者与非黏膜损伤者、软组织增厚者与非软组织增厚者置入导针所需的压力与时间。结果31例均顺利完成手术,共置入62枚椎弓根钉,6例出现轻微咽痛,5例出现咽后壁黏膜Ⅰ度损伤,7例出现软组织增厚。黏膜损伤者置入导针所需压力平均7.0 N;非黏膜损伤者置入导针所需压力平均5.5 N。黏膜损伤者置入导针所需时间平均32.5 s;非黏膜损伤者置入导针所需时间平均27.3 s。软组织增厚者置入导针所需压力平均7.1 N;非软组织增厚者置入导针所需压力平均6.0 N。软组织增厚者置入导针所需时间平均32.4 s;非软组织增厚者置入导针所需时间平均26.3 s。结论解剖型顶棒与枢椎椎体前表面契合程度较高,辅助后路C_(2)椎弓根钉内固定治疗寰枢椎不稳操作简易,安全性较高。ObjectiveTo analyze the effect of anatomical bucking bar assisted posterior C_(2) pedicle screw internal fixation on the soft tissue of posterior pharyngeal wall in the treatment of atlantoaxial instability.MethodsA retrospective analysis was performed on 31 cases of atlantoaxial instability treated by posterior C_(2) pedicle screw internal fixation assisted by anatomic bucking bar from August 2015 to December 2017.The mucosal injury and soft tissue thickening of the posterior pharyngeal wall during the follow-up period were recorded,and the pressure and time required for the insertion of the guide needle between the mucosal injury and non-mucosal injury,and the soft tissue thickening and non-soft tissue thickening patients were recorded.ResultsThe operation was successfully completed in 31 cases.A total of 62 pedicle screws were inserted.6 cases had slight pharyngeal pain,5 cases had primary injury of posterior pharyngeal mucosa,and 7 cases had soft tissue thickening.The average pressure required to insert the guide needle in patients with mucosal injury was 7.0 N;the average pressure required for insertion of the guide needle in patients with non-mucosal injury was 5.5 N.The average time required to insert the guide needle was32.5 s in the patients with mucosal injury;the average time required for the insertion of the guide needle in the patients with non-mucosal injury was 27.3 s.The average pressure required for the insertion of the guide needle was 7.1 N in the patients with soft tissue thickening;the average pressure required for the insertion of the guide needle in the patients without soft tissue thickening was 6.0 N.The average time required for the insertion of the guide needle was 32.4 s in the patients with soft tissue thickening;the average time required for the insertion of the guide needle in the patients without soft tissue thickening was 26.3 s.ConclusionAnatomical bucking bar has a high degree of fit with the anterior surface of axial vertebral body.Assisted posterior C_(2) pedicle screw fixatio

关 键 词：解剖型顶棒 HANGMAN骨折 椎弓根钉 黏膜损伤 

分 类 号：R687.3[医药卫生—骨科学]