寰枢椎后路“人”字形植骨融合钢丝固定治疗陈旧性寰枢椎脱位和不稳

Old atlantoaxial dislocation and instability treated by posterior"A"-shaped bone graft and wiring fixation

报告20例陈旧性寰枢椎脱位和不稳的后路“人”字形植骨融合钢丝内固定术的治疗方法和结果。重点讨论了寰枢椎脱位的病理改变，强调严格掌握手术适应证，即牵引可以复位同时缓解脊髓压迫。介绍了此手术的优点和提高手术安全性和效果的几点体会。

The surgical procedure and results of posterior "A"-shaped bone graft fusion and wiring fixation in 20 patients with old atlantoaxial dislocation and instability were reported in this paper. The series of patients were followed for an average period of 3 years with excellent result in 10,good in 6, progressive in 2,and poor in 2. The pathological changes of atlantoaxial dislocation, abnormal occipitoatlantoaxial complex,and distinguishing between reducible and ireducible dislocations were dicussed. It is stressed that strict contral of surgical indication. Dislocation that can be cured by traction and spinal cord compression could simultaneously be relieved. The advantages of this procedure and our experience in increasing surgical safety and improving the results were introduced.