颈前路加压螺钉内固定治疗齿状突骨折

Clinical Analysis on Internal Fixation of Cervical Anterior Compression Screw for Odontoid Fracture

目的：探讨颈前路加压螺钉内固定治疗成人齿状突骨折的临床疗效。方法：对15例成人新鲜齿状突Ⅱ型、浅Ⅲ型骨折，在C形臂X线监视下，行前路加压螺钉内固定治疗，分析其治疗效果及并发症。结果：随访8个月-5年4个月，平均11个月，X线片示骨折均获骨性愈合，无明显颈部运动受限，无螺钉断裂、移位及神经损伤等并发症，13例临床症状完全消失，2例因合并颅脑损伤者遗留头痛、头晕。结论：颈前路加压螺钉内固定技术是治疗Ⅱ型、浅Ⅲ型齿状突骨折最佳选择，具有损伤小、并发症少、固定牢靠及愈合率高等优点，正确的选择适应征、充分的术前准备和精细的手术操作是治疗成功的关键，是一种值得推广的手术方法。

Objective： To study Clinical efficacy on internal fixation of cervical anterior compression screw for odontoid fracture. Methods： 15 adult patients with the fresh type Ⅱ and superficial Ⅲ odontoid fracture were treated with internal fixation of anterior compression screw under the monitor of X-ray, its therapeutic efficacy and complication were analyzed. Results： During a follow up of 8-64months,mean 11 months, all the fractures required bony healing in X-ray sheet without complications such as neck movement limited, screw broken, screw displaced and nerve injured, clinical symptom completely obliterated in 13 of all, part of headache and dizziness leaved in 2 of all because of head injury. Conclusion ： The internal fixation of cervical anterior compression screw is the best treatment for the fresh type Ⅱ and superficial Ⅲ odontoid fracture ,with the advantages of little lesion, little complication, firm fixation and high healing. Right symptom selection, sufficient preoperative preparation and refined operative procedure are key points for the operation, and this operation method is worth extending.