U型螺钉系统固定在寰枢椎不稳中的应用

Application of U type screw fixation system in atlanto-axial instability

目的探讨运用U型螺钉系统(CUF)内固定治疗寰枢椎不稳的临床效果。方法2004年1月至2005年12月,运用自行设计的CUF行C1、2椎弓根固定治疗C1不稳8例。其中枢椎齿状突骨折7例,Jefferson骨折1例,伴颈髓损伤6例。结果术中未发生神经血管损伤,术后复查寰枢关节脱位全部纠正。CT轴位扫描,32枚椎弓根钉中有2枚钉部分进入椎管,1枚钉部分进入横突孔。3个月至2年平均6个月随访,7例达到骨性融合,无断钉断棒。结论后路椎弓根钉系统固定是目前治疗C1、2不稳的较好装置。它具有固定牢固、能提拉复位且放置方便等特点。手术成功的关键在于准确置入椎弓根钉。借助U型螺钉提拉复位的同时,配合体位复位是必要的。

Objective To investigate the clinic results of surgical treatment on atlanto-axial instability through home designed CUF screw fixation system. Metheds From January of 2004 to November 2005,8 cases of atlanto-axial instability were treated with C1-2 pedicles fixation by CUF screw fixation system, There were 7 patients of odontoid fracture with dislocations of C1-2, 1 case of Jefferson fracture with half dislocation and 6 cases with cervical cord injury, Results There were no injury of nerve and blood vessel in the period of operation. Atlanto-axial instability were all reduced after surgery. Axial Computed Tomography,2 screws went into vertebral canal partly,1 screw pierced transverse foramen partly. The patients were followed up for an average 6 months （ranged 3 to 24 months）. 7 cases all had bony fusion. Conclusion U type screw fixation system is better posterior pedicle screw system than others in the fixation system of C1- 2 pedicles. It has many virtues as follows：fixation firmly,redueing better and placing conveniently. It is a key point for surgical treatment successfully that placing screws exactly. Meanwhile it is nesessary to reduce anotmical position of the C1-2 vertebrae.