颈前路加压螺丝内固定治疗齿状突骨折

Direct Anterior Fixation of Odontoid Fractures with Compressive Cannulated Screw

目的 评价颈前路加压螺钉内固定在治疗齿状突骨折中的应用及效果。方法 对 9例急性齿状突骨折的患者 ,在透视监视下行颈前路加压螺钉内固定术并分析其结果。结果 9例患者中 ,术后除 1例病人出现短暂左上肢无力外 ,余均获得了满意疗效。随访 11～ 4 2个月 ,平均 17个月 ,齿状突骨折愈合良好 ,无不稳定或假关节形成。结论 前路直接加压螺钉内固定是治疗齿状突骨折的一种有效方法 ,在重建环—枢复合体稳定性的同时 ,完全保留了其间的运动功能。

Objective To evaluate the application and efficacy of direct anterior fixation of odontoid fractures with compressive cannulated screw.Methods From October 1998, 9 patients with odontoid fractures which included 8 cases in type Ⅱ and 1 case in type Ⅲ with a shallow base were treated by direct anterior fixation with compressive cannulated screw.Results Of 9 patients, except 1 patient with temporary weakness of left upper extremity, had excellent result.The follow-up was ranged from 11 months to 42 months, with an average 17 months.The odontoid fractures had acquired fusion, no unstability or pseudoarthritis were found.Conclusion The technique of direct anterior fixation with compressive cannulated screw is a very efficacious means for treatment of odontoid fractures and completely preserve the motion function of C 1-2 complex when spinal stability was reconstructed.The meticulous surgical technique along with appropriate patients selection will be the key of surgery.