【摘要】 目的　介绍颈后入路经C1～ 2 关节突侧块螺钉内固定技术的适应证、手术技巧和并发症 ,总结应用经验。方法　共 2 2例患者 ,其中单独采用经侧块关节螺钉内固定寰枢椎 2例 ,侧块螺钉联合钢丝内固定 8例 ,联合Apofix系统 3例 ,联合Cervifix系统作枕颈融合术 6例。所有患者术前均进行X线摄片、CT和 /或MRI检查 ,术后行颈围制动 3～ 4周。结果　 1 7例获随访 ,其中 1 6例术后半年内达骨性愈合 ,一例 1 1个月后骨性愈合。术前合并神经系统症状 1 4例 ,术后症状均有程度不等改善或完全恢复。结论　该项技术具有立即重建上位颈椎的三维稳定、骨融合率高、手术并发症少等优点。术中保持正确的体位 ,X线透视监控以及手术仔细操作可以有效地提高临床疗效更多还原

【Abstract】 Objective To investigate the indication,the technique and the complications for atlantoaxial arthrodesis with posterior C 1～C 2 transarticular screw fixation.Methods All of the 22 patients were operated on by arthrodesis with atlantoaxial facet screw fixation.Among them,8 patients added Gallie’ or Brooks’ steel wire; 3 patients of Hangman’s fracture were operated upon by C 2～C 3 fusion using Axis internal fixations.Apofix interlaminar clamping were used in 3 patients;Cervifix fixation were performed in 6 cases.Results Seventeen patients were followed up for an average of 1 5 years (ranged 5～30 months).Solid arthrodesis were obtained in 16 patients.The 14 patients with nerve injury in pre operation were recovered relatively after the operation.Conclusion Posterior C 1～C 2 transarticular screw fixation is recommended for unstable atlantoaxial vertebra due to traumatic fracture or disorders.It is emphasized that radiological analysis on operation,screw placement and seriously preparing the fusion bed are the important measures for successful operation.更多还原