【摘要】 目的探讨颈后路椎弓根螺钉内固定术治疗创伤后寰枢椎不稳及脱位的临床疗效.方法用颈后路椎弓根螺钉内固定术治疗创伤后寰枢椎不稳及脱位8例,男6例,女2例;年龄22～64岁,平均43岁.后路经寰椎侧块和枢椎峡部系统复位内固定,使寰枢椎得到稳定.结果患者平均随访11.5个月无术中、术后并发症,有神经症状者等到改善,所有患者后伸活动无明显障碍,轴向旋转活动部分丧失,X线示螺钉位置良好,无钉棒断裂、脱落、螺钉松动等现象,全部获得骨性融合.结论应用颈后路椎弓根螺钉内固定术治疗创伤后寰枢椎不稳及脱位安全可靠,疗效满意.更多还原

【Abstract】 Objective To explore the surgical feasibility and clinical outcome of transpedicle screw fixation in treatment of atlantoaxial instability and dislocation after trauma.Methods From January 2006 to June 2011,8 patients with atlantoaxial instability and dislocation were treated with transpedicle screw fixation.There were 6 males and 2 females,with a mean age of 43 years(range,22-64 years).The Screw-rod fixation system made the atlas and axis stable.Results All patients were followed up for 3-18 months,with an average of 11.5 months.All screws were successfully placed in atlas and axis.No postoperative complications such as vertebral artery injury,dural rupture,exacerbation of neurological symptoms,wound infection,and broken srews were observed in 8 cases.Neurological symptoms in some patients were improved.Postoperative radiograph and CT showed that the position of screws were satisfied.Bony fusion was observed after 6 to 18 months of operation,and atlantoaxial rotational function in all patients restored satisfactorily,but axial rotation was partially lost.Conclusion Transpedicle screw fixation in upper cervical spine for treatment of atlantoaxial instability and dislocation is safe and reliable.更多还原