颈椎椎弓根钉在强直性脊柱炎颈椎骨折中的应用

Cervical pedicle screw in the treatment of cervical fracture complicating ankylosing spondylitis

目的:探讨颈椎弓根钉在强直性颈椎炎脊柱骨折治疗中应用的效果.方法:对5例利用颈椎弓根钉治疗的强直性脊柱炎合并颈椎骨折脱位患者进行回顾性分析.5例患者神经功能按Frankel分级:A级1例,B级2例,C级和D级各1例.患者在复位后进行椎板切除减压,固定范围为受累椎体的上下各一个节段,有神经症状者进行椎板切除减压,在受累的上下各一个节段置钉.结果:术后平均3.6月(3.1～4.5月)骨折处出现愈合,内固定物无松动、断裂、脱出,1例C6置钉时损伤椎动脉,术后无脑缺血及新发神经症状.除2例Frankel A级以外,其它患者神经功能均有不同程度的恢复.结论:颈椎弓根钉具有良好的生物力学性能,对强直性脊柱炎合并颈椎骨折脱位有良好的应用前景.

Objective To determine the effect of cervical pedicle screw in the treatment of cervical fracture complicating ankylosing spondylitis. Methods A retrospective study was done in 5 patients of cervical fracture complicating ankylosing spondylitis who were treated with cervical pedicle screw. According to Frankel＇ s standard, 1 patient was in Grade A, 2 patients in Grade B and 1 patient in Grade C and 1 patient in Grade D. All patients were treated with decompression, fusion and posterior fixation with cervical pedicle screw. Results The average bony healing time was 3.6 months （3.1-4.5 months）. The instrumentation was not loose, pulled-out or ruptured. Only one C6 pedide was perforated and the vertebral artery was broken, but there was no new postoperative symptom. Three of the patients with neurological deficits improved postoperatively but the other two who were in Grade A were remained unchanged. Conclusion The good biomechanical characteristics of cervical pedicle screw help the successful treatment in the application of cervical fracture complicating ankylosing spondylitis.