寰枢椎脱位外科治疗的技术进展  

Advances in the technology of surgical treatment for atlantoaxial dislocation

作　　者：张璨[1] 陈赞[1] Zhang Can;Chen Zan(Department of Neurosurgery,Xuanwu Hospital Capital Medical University Spine Center,China International Neuroscience Institute,Beijing 100052,China)

机构地区：[1]首都医科大学宣武医院神经外科、中国国际神经科学研究所脊柱中心,北京100052

出　　处：《中华外科杂志》2024年第3期182-186,共5页Chinese Journal of Surgery

摘　　要：寰枢椎脱位病因复杂,病理形态多样。根据寰枢椎脱位的病理学解剖特点,结合临床技术制订合理的分类标准,并针对不同类别脱位制订相应的治疗策略,综合应用各种寰枢椎松解技术、复位技术、内固定技术和融合技术,才能取得外科治疗的满意效果。本文探讨了寰枢椎脱位的外科治疗技术的最新进展,详细讨论了基于不同寰枢椎脱位类型的治疗策略,分析了临床分型和治疗策略的实用性和有效性。后路寰枢椎关节松解融合技术在未来可能对传统分类和治疗策略带来的挑战,显微脊柱外科技术可能在改善手术技术和提高治疗效果方面发挥重要作用。The etiology and pathological morphology of atlantoaxial dislocation(AAD)are complex.Based on the pathological anatomical characteristics of AAD,combined with clinical techniques,it is essential to formulate reasonable classification criteria and develop corresponding treatment strategies for different types of AAD.The satisfactory outcome of surgical treatment for AAD can only be achieved through the comprehensive application of various atlantoaxial reduction techniques,tension band releasing techniques,internal fixation and fusion techniques.This article discusses the latest advancements in surgical treatment techniques for AAD,thoroughly explores treatment strategies based on different types of AAD,and analyzes the practicality and effectiveness of clinical classification and treatment strategies.The posterior atlantoaxial facet releasing and distraction compression reduction technique may pose challenges to traditional treatment strategies in the future.In the development of surgical treatment techniques for AAD,microspinal surgical techniques may play a significant role in improving surgical methods and enhancing treatment outcomes.

关 键 词：寰枕关节 先天畸形 寰枢椎脱位 颅底凹陷 颅颈交界区畸形 关节间撑开 枕颈内固定 

分 类 号：R687.4[医药卫生—骨科学]