【摘要】 目的评价采用寰枢椎椎弓根钉内固定植骨融合术治疗不稳定寰椎骨折的疗效。方法对不稳定寰椎爆裂骨折20例行后路寰枢椎椎弓根钉内固定植骨融合术。术中利用寰椎椎弓根钉的横向加压作用对侧块分离进行矫正,并利用寰椎椎弓根钉的后向提拉作用对术前寰椎复位不佳者给予进一步复位。结果患者均获随访24个月,术后3个月临床症状均完全缓解。术后3个月ASIA评分的运动、轻触及针刺评分分别是(99.85±0.37)、(111.80±0.52)、(111.95±0.22)分,较术前显著提高(P<0.05)。术后3个月影像学资料提示内固定位置良好、骨折愈合,无寰枢关节不稳征象。结论在充分的术前准备下,寰枢椎椎弓根钉植骨内固定术是一种有效的治疗不稳定寰椎爆裂骨折的方法。更多还原

【Abstract】 Objective To evaluate the clinical outcome of C1、2 pedicle screw fixation and bone grafts for the treatment of unstable altantal bursting fracture.Methods Twenty patients with unstable atlantal burst fractures were operated on with C1、2 pedicle screw fixation and bone grafts.After pedicle screws of atlas were successfully implanted,the use of atlas pedicle screws and connecting rods resulting in lateral pressure effects can correct atlantallateralmass separation;For the patients with an unsatisfactory preoperative atlantoaxial dislocation,use of the connecting rod and pedicle screws of atlas resulted in the pulling effect to further reduce the dislocation.Results All patients were followed up for 24 months.All patients showed complete improvement of clinical symptom.On three months after surgery,ASIA motor,touch,and acupuncture scores were respectively(99.85±0.37),(111.80±0.52),(111.95±0.22),the difference between preoperative ASIA scores and three months after surgery was significant(P <0.05).On three months after surgery,the cervical spine images showed that there were good positions of internal fixations,healing of fracture and no appearances of instability.Conclusion Under full preoperative preparations,C1、2 pedicle screw fixation and bone grafts is a relatively safe and effective method to manage the unstable atlantal burst fractures.更多还原