后路椎弓根螺钉治疗齿状突骨折伴可复性寰枢椎脱位

Treatment of dens fracture combined with recoverable atlantoaxial dislocation with posterior fusion plus pedicle screw

目的总结后路寰枢椎椎弓根螺钉固定、复位、融合治疗齿状突骨折伴可复性寰枢椎骨折脱位的疗效。方法对27例齿状突骨折伴可复性寰枢椎骨折脱位的患者经术前颅骨牵引，采用后路椎弓根螺钉，行寰枢椎复位、固定及植骨融合。结果患者寰枢椎椎间稳定性得到恢复，无并发症发生；随访12—48个月（平均24个月），27例患者均获骨性融合。结论经后路寰枢椎椎弓根螺钉固定融合术可为齿状突骨折伴可复性寰枢椎骨折脱位的患者提供牢固的三维固定，是一种更为有效的治疗方法。

Objective To summarize the clinical results of posterior fusion plus pedicle screw fixation in treatment of dens fracture combined with recoverable atlantoaxial dislocation. Methods Twenty-seven patients with dens fractures combined with recoverable atlantoaxial dislocation were treated with posterior pedicle screw fixation, reduction and fusion. In this series of patients, skull traction was made to restore the normal atlantoaxial joint before the operation. Results Atlantoaxial alignment or stability were restored, without complication due to instrumentation. A follow-up for 12-48 months （average 24 months） showed osseous union. Conclusion Posterior atlantoaxial pedicle screw and rod fixation provides immediate three-dimensional rigid fixation of atlantoaxial joint and is a more effective technique compared with previously reported techniques.