后路寰枢椎椎弓根钉固定融合治疗寰枢椎不稳或脱位

Treatment of atlantoaxial instability or dislocation by posterior pedicle screw-rod internal fixation and fusion

目的探讨颈后路寰枢椎椎弓根钉固定融合治疗寰枢椎不稳或脱位的临床效果。方法对25例寰枢椎不稳或脱位患者采用后路寰枢椎椎弓根螺钉系统复位固定并植骨融合治疗。结果所有患者术中无椎动脉及脊髓损伤发生,术后枕颈部不适症状均不同程度消失,受损脊髓神经功能改善明显。25例均获随访,时间12～36（18±6）个月。末次随访时,无螺钉断裂、松动或移位,颈椎复位满意,无寰枢椎再移位,失稳现象发生,全部获得骨性融合;颈椎屈曲功能良好,旋转功能轻度受限。结论后路寰枢椎椎弓根钉固定融合术是治疗寰枢椎不稳或脱位的有效方法。

Objective To explore the clinical effects of posterior pedicle screw-rod internal fixation and fusion in the treatment of atlantoaxial instability or dislocation. Methods 25 patients with atlantoaxial instability or dislocation were treated with posterior pedicle screw-rod internal fixation and fusion. Results No injury of spinal cord and veterbral artery were happened in the operations,all craniocervical symptoms disappeared to different degree and functions of injured spinal cord were improved obviously after operations. 25 patients were followed up for 12 ～ 36（ 18 ± 6）months. At the last follow-up,no internal fixation breakage,loosening or broken rods,atlantoaxial re-displacement and instability occurred,all grafting bone was fused well. Cervical inflexion was fine,but there was mild limitation for rotation function. Conclusions Posterior pedicle screw-rod internal fixation and fusion is effective in the treatment of atlantoaxial instability or dislocation.