寰枢椎椎弓根螺钉置钉技术的临床应用

Clinical application of atlantoaxial pedicle screw system fixation

目的探讨寰枢椎椎弓根螺钉置钉技术在上颈椎损伤临床应用的效果。方法选择性应用寰枢椎椎弓根螺钉固定技术治疗Jefferson骨折5例,齿状突骨折11例,Hangman骨折9例。结果术中无椎动脉、脊髓及神经根损伤发生。1例暴露时损伤静脉丛,予以压迫即能止血;1例寰枢椎骨折不完全复位。患者均获随访,时间1~2年。患者临床症状明显改善,术后1年行X线及CT检查,显示所有骨折均骨性愈合,螺钉位置良好,无松动、断钉。结论寰枢椎椎弓根螺钉内固定技术具有固定可靠及骨折愈合率高等特点,为上颈椎损伤提供了坚固的稳定性。

Objective To investigate the effect of atlantoaxial pedicle screw system fixation to treat upper cervical injuries. Methods Patients with upper cervical injuries were treated with atlantoaxial pedicle screw system fixation,which included 5 cases of Jefferson fractures,11 odontoid fractures and 9 Hangman fractures. Results No patient had the injury of spinal cord,nerve root and vertebral artery. There was 1 case with vertebral vein injury,which had been controlled by compression. 1 case with Jefferson fracture showed incomplete reduction. All patients were followed up from 1 year to 2 years. All fusion bone got union from CT scan and X-ray a year after surgeries. The clinical symptoms were improved and the screws were verified to be in a proper position without breakage or loosening. Conclusions The atlantoaxial pedicle screw system fixation is an effective method,which provide stable fixation and high fusion rate for fracture to treat upper cervical injuries.