Cervifix在陈旧性寰枢椎脱位并高位颈髓压迫症中的应用

Cervifix internal fixation system for the treatment of old atlanto-axial dislocation with incomplete spinal cord injury

目的:探讨Cervifix内固定系统治疗陈旧性寰枢椎脱位并脊髓不全损伤的价值。方法:36例陈旧性寰枢椎脱位并脊髓不全损伤行后路融合、Cervifix内固定。男23例、女13例,年龄15～62岁,平均38.3岁。陈旧性外伤21例,先天性畸形9例,类风湿性关节炎伴寰椎前脱位6例。结果:随访8～42个月,平均19个月。术后脊髓功能按JOA17分法评定,改善率为71.4％。全部患者均获骨性融合,内置物无松动、断裂及脊髓损伤加重等并发症。结论:Cervifix内固定可提供坚强有效的节段性固定,提高融合率。同时,可预防单纯减压融合术后早期失稳导致的高位脊髓损伤加重。

Objective : To study effect of cervifix internal fixation while decompression and fusion for the treatment of old atlantoaxial dislocation with incomplete spinal cord injury. Method:Thirty-six cases of old atlantoaxial dislocation with incomplete spinal cord injury underwent decompression fusion and Cervifix internal fixation,23 males and 13 females, with a mean age of 38. 3 years. Among them,21 cases due to trauma,9 cases with congenital deformity,8 cases with rheumatoid arthritis. Result:With followed-up from 8 months to 42 months (mean 19 months). JOA scores improving rates was 71.4%. X-ray films demonstrated complete fusion in all the 36 patients. There were no displacement and deterioration of neurofunction in all patients. Canclusion: Cervifix internal fixation of the occipital-cervical junction can provide immediate rigid stability and maintain axial correction for the segment while decompression and fusion for the treatment of old atlantoaxial dislocation with incomplete spinal cord injury.