后路经寰枢椎椎弓根固定重建寰枢关节稳定性

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目的:总结后路经寰枢椎椎弓根固定重建寰枢关节稳定性的临床疗效。方法:2006年9月-2012年6月,共收治寰枢关节稳定性丧失患者47例,男32例,女15例,年龄21~71岁,平均40.30±5.65岁。其中新鲜齿状突骨折伴稳定性丧失15例,横韧带断裂5例,陈旧性齿状突骨折17例,先天性游离齿状突3例,先天性短小齿状突3例,类风湿性关节炎4例,寰枢关节不稳28例,寰枢关节脱位19例。神经功能根据JOA脊髓功能评分法评定,9-17分,平均11.50±1.37分。所有寰枢关节脱位患者在麻醉状态下颅骨牵引均已复位,所有患均采用后路经寰枢椎椎弓根固定行稳定性重建。结果:所有患者平稳渡过围手术期,并获得18-69个月随访,平均38.52±5.66个月。所有患者均获得解剖复位和植骨融合,末次随访时神经功能J O A评分12-17分,平均14.50±1.50分。结论:后路经寰枢椎椎弓根固定重建寰枢关节稳定性,具有操作简单、复位充分、固定坚强、融合率高等优点,是重建寰枢关节稳定性安全有效方法。“,”Objective: To summarize the therapeutic effect of surgical treatment of atlantoaxial stability reconstruction through pedicle fixation Methods: 47cases of atlantoaxial instability were treated in our hospital from Sep.2006 to Jun .2012 , among the total , 32 males and 15females,with the age from21years to 71 years , the average 40.30±5.65years ,including 15 patients with fresh odontoid process fracture, 5 patients with ligamentum transversum broken,17patients with obsolete odontoid process fracture, 3 patients with inborn dissociation odontoid process, 3 patients with inborn short and smal odontoid process, 4 patients with rheumarthritis , 28 patients with atlantoaxial instability , 19patients with atlantoaxial dislocation . the Japanese Orthopaedic Association (JOA) score was from 9 to 17, the average 11.50±1.37.Al dislocation could be reduced through skul traction under drugged state, Al patients were performed with posterior fixation through atlantoaxial pedicle . Results: Al patients pul ed through the period time of operation securely. Al patients were fol owed up from 18to 69 months , the average 38.52±5.66 months.Al gained anatomic reduction and bone fusion.By the latest time fol owed up ,the JOA score was from 12to 17, the average 14.50±1.50.Conclusion: Surgical treatment of atlantoaxial instability reconstruction through pedicle fixation have the merits of simple operation , sufficient reduction, firm fixation ,high rate of fusion , which is a safe and effective technique for the treatment of atlantoaxial instability .
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