颅颈交界区畸形相关疾病的诊治进展  

Advances in the diagnosis and treatment of craniovertebral junction abnormalities

作　　者：葛礼豪 许南方 田英轮 高阳[1] 侯翔宇 王圣林[1] Ge Lihao;Xu Nanfan;Tian Yinglun;Gao Yang;Hou Xiangyu;Wang Shenglin(Department of Orthopedics,Peking University Third Hospital,Engineering Research Center of Bone and Joint Precision Medicine,Beijing Key Laboratory of Spinal Disease Research,Beijing 100191,China)

机构地区：[1]北京大学第三医院骨科、骨与关节精准医学工程研究中心、脊柱疾病研究北京市重点实验室,北京100191

出　　处：《中华外科杂志》2025年第3期259-264,共6页Chinese Journal of Surgery

基　　金：北医三院临床队列研究建设基金(BYSYDL-2021016)。

摘　　要：颅颈交界区畸形常发病隐匿,临床表型多样,且常合并多种畸形,使对其进行系统性分类、分型更加困难。目前临床上常将颅颈交界区畸形分为先天性和后天性,也可根据其部位可分为颅底畸形、寰椎畸形、枢椎畸形等。对于存在明显枕颈区或寰枢关节不稳、合并高位颈脊髓损害症状的患者,应积极行内固定融合手术,以免造成不可逆的神经损伤。既往文献对颅颈交界区畸形相关疾病的治疗缺乏详细的归类和总结,且对部分畸形的治疗策略仍存在争议,国内外相关文献对该疾病的认知和治疗理念亦不尽相同。本文对颅颈交界区畸形疾病的临床特点、诊治进展进行综述。Craniocervical junction zone malformations often have an insidious onset,a variety of clinical phenotypes,and are often combined with multiple malformations,making their systematic classification and staging more difficult.At present,craniocervical junction area malformations are often classified into congenital and acquired,and can also be classified into skull base malformations,atlantoaxial malformations,and cardinal malformations according to their locations.For patients with obvious occipitocervical or atlantoaxial instability,combined with symptoms of high cervical spinal cord damage,internal fixation and fusion surgery should be performed aggressively to avoid irreversible nerve damage.There is a lack of detailed categorisation and summary of the treatment of diseases associated with craniocervical junction malformations in the literature,and the treatment strategies for some of these malformations are still controversial,with different perceptions and treatment concepts in the national and international literature.

关 键 词：寰枕关节 先天畸形 颅颈交界区畸形 症状和体征 治疗 综述 

分 类 号：R68[医药卫生—骨科学]