后路经关节螺钉联合Brook融合术治疗陈旧性齿状突骨折

Combined Magerl and Brooks Techniques in Treatment of Old Odontoid Fractures

目的介绍一种后路内固定治疗陈旧性齿状突骨折的手术方式。方法对8例陈旧性齿状突骨折采用后路C1、2经关节螺钉联合Brooks融合术治疗。结果8例中7例共放置经关节螺钉14枚,1例因C2单侧椎板上缘劈裂仅行Brooks融合术,术中无椎动脉硬脊膜破裂和脊髓损伤等并发症。随访3～32个月,植骨全部融合。结论后路经关节螺钉联合Brooks融合术是治疗陈旧性齿状突骨折的有效方法,可提供有效的固定和提高植骨融合率。

Objective To introduce a method of posterior fixation for old odontoid fractures with atlanto - axial instability. Methods Eight patients with type Ⅱ old odontoid fractures with atlanto- axial instability were treated with the combined Brooks technigue and posterior atlanto- axial transarticular screw insertion. Results Fourteen transarticular screws were totally placed in 7 patients. One patient with fracture of the upper edge of the single axial vertebral lamina was treated only with Brook technigue. There were no complications such as the failures in the internal fixation, vertebral artery injury and spinal cord injury. All the patients underwent a follow-up for 3 to 32 months and had bone graft fusion by radiographs. Conclusion To maximize spinal stability and improve fusion rate, the combined use of Magerl and Brook techniques is an effective method for the treatment of old odontoid fractures.