枢椎椎板螺钉联合寰椎侧块螺钉固定技术在复杂寰枢椎脱位中的应用

Application of axial laminar screws combined with atlantal lateral mass screws fixing method in the surgery of complicated atlantoaxial dislocation

目的探讨枢椎椎板螺钉联合寰椎侧块螺钉固定技术在复杂寰枢椎脱位中的应用。方法对6例合并枢椎椎弓根发育不良或粉碎性骨折的寰枢椎脱位患者,行枢椎椎板螺钉联合寰椎侧块固定,辅以寰枢椎间植骨融合的手术治疗。结果所有患者术后复位及即刻稳定性良好,随访观察寰枢椎骨性融合良好,无椎动脉或脊髓损伤的情况,无寰枢椎以外颈椎节段椎间骨性连接。结论在合并枢椎椎弓根发育不良或粉碎性骨折的寰枢椎脱位中,应用枢椎椎板螺钉联合寰椎侧块固定技术可取得良好效果。

Objective To explore the application of axial laminar screws combined with the atlantal lateral mass screws fixing method in surgery of complicated atlantoaxial dislocation. Methods 6 cases of atlantoaxial dislocation complicated by dysplasia or comminuted fracture of the axial pedicle root were involved in the study. Axial laminar screws combined with the atlantal lateral mass screws fixing method was performed on the patients,followed by fusing of the atlantoaxial joint using bone grafts. Results Satisfying reduction and stability of the cervical spine were shown in the X-ray film and CT image instantly after surgery. Adequate atlantoaxial fusion was shown in the X-ray film during follow-up. No evidence indicated vertebral artery or spinal cord injuries. Conclusion Axial laminar screws combined with the atlantal lateral mass screws fixing method has a perfect effect on the surgery of atlantoaxial dislocation complicated by dysplasia or comminuted fracture of the axial pedicle root.