寰枢椎椎弓根螺钉固定技术治疗陈旧性难复性寰枢椎前脱位

Surgical Treatment with Atlantoaxial Pedicle Screws for Old irreducible Anterior Atlantoaxial Dislocation

目的探讨陈旧性难复性寰枢椎前脱位后路椎弓根植骨融合内固定的手术方法和疗效。方法对 2004 年 8 月～2007 年 7 月收治的 16 例因陈旧性齿状突骨折导致的难复性寰枢椎前脱位患者,采用寰枢椎经椎弓根螺钉固定术行后路植骨融合,观察术后寰枢椎复位及植骨融合效果。结果所有患者均得到随访,随访时间 11 个月～3.8 年,平均 2.2 年,寰枢椎脱位复位程度均达 90%以上,所有患者椎间植骨均融合,无内固定断裂、移位。结论后路寰枢椎经椎弓根螺钉固定术是治疗陈旧性难复性寰枢椎脱位的有效方法。

Objective To analyze the surgical treatment and effect of pedicle screws for the old anterior in＇educible aflantoaxial dislocation. Methods Sixteen cases of anterior irreducible atlantoaxial dislocation due to old odontoid fracture from Aug. 2004 to Jul. 2007 were surgically treated by post atlantoaxial pedicle screws systems, and the effect of the atlantoaxial reposition and fusion was observed. Resuits After mean follow-up of 2.2 years, the outcome of surgical treatment showed over 90% reposition and 100% fusion rate in all cases without fixation break or displacement. Conclusion The post adantoaxial pedicle screws fixation system is the effective method of treating old irreducible atlantoaxial pre-dislocation.