AOSF技术治疗Ⅱ型和浅Ⅲ型齿状突骨折疗效分析

The Analysis of Curative Effect of Anterior Odontoid Screw Fixation for Treating Type Ⅱ and Shallow Type Ⅲ Odontoid Fractures

目的探讨前路齿状突螺钉内固定技术治疗Ⅱ型和浅Ⅲ型齿状突骨折安全性和临床疗效。方法应用前路齿状突螺钉内固定技术治疗齿状突骨折32例,男23例,女9例。年龄19～78岁,平均（52.6±3.2）岁。按A nderson-D′Alonzo分型,Ⅱ型20例,浅Ⅲ型12例。均采用1枚空心加压螺钉固定。通过上颈椎正侧位及张口位X线片和CT进行评价。结果32例均获得随访,随访时间6～28月,平均18个月。除2例Ⅱ型骨折未愈合外,其余平均愈合时间6个月。无螺钉断裂、移位及神经损伤等并发症。临床症状完全消失26例,3例遗留颈部僵硬感,但临床检查无活动受限,2例合并颅脑损伤者残留部分头痛、头晕。结论前路齿状突螺钉内固定技术是治疗Ⅱ型和浅Ⅲ型齿状突骨折有效和安全的方法,能最大限度地保留寰枢椎的生理活动功能。

Objective To investigate clinical effect and safety of anterior odontoid screw fixation（AOSF） for treating type Ⅱ and shallow type Ⅲ odontoid fractures.Methods 32 cases of type Ⅱ（20 cases） and shallow type Ⅲ（12 cases） odontoid fractures were treated by anterior odontoid screw fixation.Male 23 cases,female 9 cases,mean age（52.6±3.2） years,range：from 19 to 78 years.All cases use single-screw fixation.Imaging studies were used to analyze the surgery-related results in these patients.Results All patients were followed-up for an average of 18 months（range 6～28 months）.Bony fusion was average obtained for 3 months except for 2 cases which are type II odontoid fractures.The guide pin was broken in one case.There were no loosening or break of the screw and nerve injury.The clinical symptom and signs had completely disappeared in 26 cases.There was cervical stiffness in 3 cases,There was residual headache and dizzy in 2 cases.Conclusion AOSF techniques is an effective and safe method for treating type Ⅱ and shallow type Ⅲ odontoid fractures.and it can preserve normal C1-2 motion.