【作者】 李波；

【导师】 张宏其；

【作者基本信息】 中南大学 ， 临床医学， 2013， 硕士

【摘要】 目的：观察Magerl术结合术中松解复位治疗创伤性寰枢椎失稳临床疗效和应用价值。方法：对35例创伤性寰枢椎失稳的患者病例做回顾性分析(2007年2月至2010年12月)。平均年龄33.5岁,其中男性23例,女性12例。术前均行颅骨牵引。术中一期后路采用Magerl术结合术中松解复位治疗。观察术后近期、远期疗效及并发症情况。结果：随访6-33个月,平均18.8月,所有患者均采用Magerl术结合术中松解复位治疗。术后患者症状均明显改善,未发生螺钉或钛缆断裂,无脊髓和椎动脉损伤及术后感染等其他并发症。末次随访时螺钉及寰枢椎相对位置满意,植骨均获骨性融合,无寰枕关节活动受限及相邻节段的明显退变。结论：Magerl术结合术中松解复位治疗创伤性寰枢椎失稳是安全、有效的方法。寰枢关节未完全复位的,只要能够达到确切固定,与完全复位病例,临床效果无明显差异。更多还原

【Abstract】 Objectives:To evaluate the feasibility and efficacy of combined Magerl technique with intraoperative release for the treatment of traumatic atlantoaxial instability.Methods. From January2007to December2010,35patients with incompletely-reduced atlantoaxial instability were treated with bilateral C1-2posterior transarticular screw fixation, of these, all of cases with C1posterior arch intact underwent one-stage Magerl surgery combined with C1-2posterior Gallie surgery. These patients’ clinical outcomes postoperative CT scan was performed to assess the instrumentation. Short term and long term efficacy and complications were recorded.Results:All patients underwent surgery successfully, without severe complications such as injury of nerve or blood vessels, neurological function improved remarkably. All patients were followed up for6～33months(mean,18.8months). C1-2dislocation(anteriorly and laterally) was evidenced radiographily in some patients no screw perforation was documented. The atlanto-occipital joint was kept intact in all cases. All patients got C1-2bony fusion within3to6months postoperatively.Conclusions:Combined Magerl technique with intraoperative release can be feasible and safe for patients with incompletely-reduced atlantoaxial instability. Atlantoaxial joint is not completely reset, as long as they meet the exact fixed, and completely reset cases, no significant difference in clinical outcomes.更多还原