后路经侧块关节螺钉内固定技术治疗寰枢椎不稳

Treatment of atlantoaxial instability with C1-C2 posterior transarticular screw fixation

目的:评价Magerl法内固定治疗寰枢椎不稳或脱位的临床疗效。方法:寰枢椎不稳14例,男10例,女4例;年龄17～62岁,平均38.6岁。均实施后路复位,Magerl法经关节螺钉内固定和自体髂骨植骨。结果:14例患者共植入经关节螺钉28枚。所有患者获随访,时间9～35个月,平均16个月,术后JOA评分13.8～15.8分,平均(14.50±0.66)分。改善率平均(76.12±4.94)%。术后无椎动脉和脊髓损伤发生,植骨全部融合。结论:Magerl法固定是治疗寰枢椎不稳的良好方法之一,无须加用结构性植骨和辅助内固定,自体颗粒状松质骨植骨即可实现有效的骨性融合。

Objective ：To evaluate the technique of C1-C2 transarticular screw fixation for atlantoaxial instability or dislocation. Methods：Among 14 patients with atlantoaxial instability, 10 were male and 4 patients were female,with an average age of 38.6 years ranging from 17 to 62 years. All patients were treated by internal fixation with transarticular screws. Results： There were 28 screws applied in 14 patients. All patients were followed up, The average follow-up period was 16 months （range,9 to 35 months）. The postoperative JOA score was ranging from 13.8 to 15.8 with the average score of （14.50±0.66）and the improved rate of（76.12±4.94）%. No spinal injury and vertical artery injury was found and osseous fusion was completed in all patients. Conclusion ：The technique of C1-C2 transarticular screw fixation is one of the best treatments for atlantoaxial instability. Without the help of structural bone graft and aided internal fixation ,morselized cancellous bone graft can acquire effective osseous fusion.