论文部分内容阅读
目的：分析后路寰枢椎钉棒系统临时固定治疗新鲜枢椎齿突骨折的临床疗效。方法回顾分析2006年1月—2015年4月行后路寰枢椎钉棒临时固定治疗的43例新鲜枢椎齿突骨折患者（非融合组）的临床资料，其中41例齿突骨折愈合后取出内固定。同时，以相同入选标准选取同期行后路寰枢椎融合固定术治疗的41例患者（融合组）作为对照。观察骨折愈合情况及寰枢椎稳定性。术后应用疼痛视觉模拟量表（VAS）评分、颈椎功能障碍指数（NDI）、颈部僵硬度及患者满意度对临床效果进行评价。结果非融合组和融合组随访时间分别为（31.3±16.1）个月、（33.6±15.7）个月，2组患者术后均未发生脊髓和椎动脉损伤、感染、内固定松动及寰枢椎不稳等情况。非融合组患者术后在VAS评分、NDI、颈部僵硬度及患者满意度方面均优于融合组，差异有统计学意义（P0.05）。结论后路寰枢椎钉棒临时固定技术既可保留寰枢椎生理功能又能获得良好临床疗效，对于不适合前路齿突螺钉固定的横韧带完整的齿突骨折是一种理想的替代手术方式。“,”Objective To confirm the clinical efficacy of posterior atlantoaxial temporary fixation for the treatment of fresh odontoid fracture.Methods Frome January 2006 to April 2015,clinical data of 43 patients suffering from odontoid fracture treated with atlantoaxial temporary fixation without bone grafting(non-fusion group) were analyzed retrospectively,and internal fixators were removed after fracture union in 41 patients. Meanwhile,41 patients suffering from odontoid fracture treated with posterior atlantoaxial fixation and fusion(fusion group) were chosen as control. Condition of fracture healing and stability of atlantoaxial joint were observed. Clinical efficacy was evaluated by the visual analog scale(VAS) score for neck pain,neck disability index(NDI),neck stiffness and patient satisfaction.Results The postoperative follow-up period was (31.3±16.1) months in non-fusion group and (33.6±15.7)months in fusion group. No serious postoperative complications,such as spinal cord and vertebral artery injury,infection,internal fixation loosening and atlantoaxial instability occurred in both groups. The results of VAS score,NDI,neck stiffness and patient satisfaction were better in non-fusion group;the difference was statistically significant(P0.05).Conclusion As a technique of preserving motion,temporary atlantoaxial screw-rod fixation is a alternative surgical method for treatment of fresh odontoid fracture without transverse ligament injury when anterior screw is not suitable.