寰枢椎经椎弓根螺钉固定技术的临床应用

The exploration of the security of the internal fixation with AXIS plate screw technique via the atlanto-axial pedicle

目的:探讨经椎弓根螺钉固定技术治疗寰枢椎不稳定的临床疗效及其安全性。方法:对2002年12月￣2003年12月收治的13例寰枢椎不稳定患者施行经椎弓根AXIS钢板螺钉固定术,应用动力位X线片及CT检查寰枢椎稳定程度,记录每一例患者的术中并发症及术后功能恢复情况。结果:未发生神经及血管损伤等术中并发症。术后随访3￣15个月,平均9个月,13例患者疼痛均明显减轻,无加重患者,唯旋转功能较差。X线片复查内固定位置良好,无松动及断裂,4例已骨性融合。结论:经椎弓根钢板螺钉固定技术是治疗寰枢椎不稳定的有效方法,但技术要求高,需谨慎操作。

Objective：To explore the clinical outcomes and security of technique of transpedicular instrumentation in atlanto-axial distability.Method：From December 2002 to December 2003,13 eases with atlanto-axial distahility undergoing the transpedicular screw system（AXIS） were reviewed.All the cases were followed up for 3-15 months,averaging 9 months.The intraoperative complications and the postoperative neurological recovery of each case were documented.Dynamic radiograph and digital tomography were used to evaluate the extent of the atlanto-axial vertebrae stability.Result：All cases were observed free from neurovascular complication.After the mean follow-up of 9 months, 13 patients had significant pain relieve,while the rotation was definitely limited.Nn instrumenlaton failure was noted,and bony fusion was documented in 4 cases.Conclusion：Transpedicular instrumentation is effective in dealing with atlanto-axial distability with promising security,however masterful experience are required,which should be performed with caution.