微创经口咽复位内固定钢板在青少年寰枢椎手术的运用效果  

Applicationeffect of minimally invasive transpharyngeal reduction and internal fixation plate on atlantoaxial surgery for adolescents

作　　者：童磊[1] 贾锋[2] TONG Lei;JIA Feng(Trauma Center,Nanyang Central Hospital,Nanyang,Henan 473000,China;Department of Neurology,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院,创伤中心,河南南阳473000 [2]南阳市中心医院,神经内科三病区,河南南阳473000

出　　处：《颈腰痛杂志》2022年第5期643-645,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 探讨微创经口咽复位内固定钢板在青少年寰枢椎手术的运用效果。方法 纳入2016年3月~2018年3月我院收治的32例青少年寰枢椎脱位患者,男18例,女14例,年龄12~15岁,平均(15.76±1.04)岁。所有患者均采用经口咽复位联合Slim-TARP钢板内固定治疗,随访2~4年,平均(3.01±0.28)年。记录围手术期情况,术前、术后6个月、末次随访时采用JOA评分、VAS评分评价颈椎功能及疼痛程度,并记录围手术期及随访阶段并发症发生情况。结果 32例患者均完成手术,手术时间(88.76±14.87)min,出血量(96.86±19.31)mL,住院时间(9.87±2.31)d,骨性愈合时间(4.46±0.81)个月;术后1例患者出现声音嘶哑,1例术中硬脊膜破裂,无内固定松动、脱落、感染、严重继发性神经损伤发生。术后6个月、末次随访JOA评分、VAS评分均获得显著改善,差异有统计学意义(P<0.05)。结论 微创经口咽复位Slim-TARP钢板内固定治疗青少年寰枢椎脱位,创伤轻、并发症少,能有效改善疼痛症状及颈椎功能。Objective To discuss the application effect of minimally invasive transpharyngeal reduction and internal fixation plate on atlantoaxial surgery for adolescents.Methods Thirty-two adolescents with atlantoaxial dislocation in our hospital from March 2016 to March 2018 were selected in this study,including 18 males and 14 females.They were 12 to 15 years old,with an average of(15.76±1.04)years old.All patients were treated with transpharyngeal reduction combined with Slim-TARP plate internal fixation,followed up for 2 to 4 years,with an average of(3.01±0.28)years.The perioperative conditions were recorded,and the Japanese orthopaedic association(JOA) score and visual analog scale(VAS) pain score were used to evaluate cervical spine function and pain level before operation,6 months after operation,and at the last follow-up.The complications were recorded at perioperation and follow-up.Results All 32 patients completed the operation,the average operation time was(88.76±14.87)min,the bleeding volume was(96.86±19.31)mL,the hospital stay was(9.87±2.31)d,and the bone healing time was(4.46±0.81)months.After operation,1 patient had hoarseness,and 1 patient had a dura rupture during the operation.There were no loosening of internal fixation,shedding,infection,or serious secondary nerve injury.At 6 months after operation and the last follow-up,JOA score and VAS score were significantly improved,the differences were statistically significant(P<0.05).Conclusion Minimally invasive transpharyngeal reduction with Slim-TARP plate internal fixation for adolescents with atlantoaxial dislocation has less trauma and fewer complications,and can effectively improve pain symptoms and cervical spine function.

关 键 词：微创经口咽复位 内固定钢板 青少年寰枢椎脱位 

分 类 号：R687.3[医药卫生—骨科学]