颈前路单枚空心螺钉治疗齿状突Ⅱ型骨折疗效分析

Clinical efficacy of odontoid anterior single-screw fixation for typeⅡ odontoid fracture

目的探讨颈前路单枚齿状突空心螺钉治疗Ⅱ型齿状突骨折的疗效。方法 2005年8月至2010年7月,我科收治35例Ⅱ型齿状突骨折(屈曲型25例,伸展型10例),男23例,女12例;年龄15～71岁,平均34岁。患者均未见明显神经压迫症状,术前均行颅骨牵引,完全复位30例,未完全复位5例。为防止术后骨不连,所有患者行颈前路电视下闭合复位单枚空心螺钉内固定术。结果所有患者均获得随访,随访时间6～60个月,平均36个月,平均手术时间105min,颈部疼痛症状完全缓解,颈椎生理曲度保持良好,骨折愈合率100%,无内固定松动、断钉等并发症。结论应用颈前路单枚齿状突空心螺钉治疗Ⅱ型齿状突骨折,是一种安全、有效的治疗方法。

Objective To observe the clinical effect of anterior single - screw fixation for typeⅡodontoid fracture. Methods From August 2005 to July 2010,35 patients（average 34 years,range：15 -71 years,23 males and 12 females） with typeⅡodontoid fracture underwent anterior single - screw fixation.Spinal cord compression was not found in any patient.The diagnostic categories included 25 flexion fractures and 10 extension fractures.In all the cases,traction was adopted before operation.Complete reduction was obtained in 30 cases.In order to prevent the nonunion of the fractures, anterior single - screw fixations were adopted for all patients.Results The follow - up periods for all the 35 patients ranged from 6 to 60 months with an average of 36 months.The average operating time was 105 minutes.No patients experienced worsening neurological postoperatively.No other intra - or post - operative complication was observed.All patients axial pain was relieved after surgery.Each patient can maintain good cervical physiological curvature.Each patient obtained bone healing within 10 months（average 5 months）.No screws complication was observed in any of the follow - up period.Conclusion A nterior single - screw fixation may be a feasible and safe way to treat type II odontoid fracture.