经后路钉棒内固定治疗创伤性寰枢椎不稳

Internal fixation with posterior screw-rod system for traumatic atlantoaxial dislocation

目的探讨经寰椎侧块及枢椎椎弓根钉棒内固定治疗创伤性寰枢椎不稳定的方法和疗效。方法对10例创伤性寰枢椎不稳定患者采用经寰椎侧块枢椎椎弓根钉棒内固定、植骨融合术,观察术后近期疗效及并发症。结果术中未发生血管神经等重要组织结构的损伤,术后症状均得到明显改善。10例全部获得随访,时间6~24个月。无内固定物松动及断裂,所有植骨均达骨性融合。结论采用经寰枢椎椎弓根钉棒内固定可以即刻重建寰枢椎稳定性,疗效满意,为治疗创伤性寰枢椎失稳提供了一种较理想的内固定术式。

Objective To explore the surgical feasibility and clinical outcome of internal fixation with lateral mass screw of atlas and axis pedicle screw for traumatic atlantoaxial dislocation.Methods A series of 10 cases with traumatic atlantoaxial dislocation were treated by internal fixation with lateral mass screw of atlas and axis pedicle screw and bone graft fusion.The immediate outcome and complications were observed.Results There was no vascular or neural injury was found in the operation on the 10 patients and after the followed up period of 6～24 months.The clinical symptoms were improved after operation.No looseness or breakage of the screws occurred.Bony fusion was achieved in all the cases.Conclusions Screw-rods instrument in the pedicle of atlas and axis can immediately make the atlantoaxial joint stable in three-dimension.It is a better alternative for traumatic atlantoaxial dislocation.