寰枢椎椎弓根螺钉内固定融合术治疗上颈椎伤病疗效

Application of atlas and axis pedicle screw system fixation and fusion for treatment of upper cervical invaliding

目的探讨经后路寰枢椎椎弓根螺钉内固定融合术治疗上颈椎伤病的疗效。方法采用后路寰枢椎椎弓根螺钉内固定融合术治疗12例上颈椎伤病患者,并行自体髂骨植骨。其中,先天性齿状突不连1例,陈旧齿状突骨折2例,新鲜齿状突骨折5例,寰椎横韧带断裂1例,颈1/2融合翻修2例,寰枢椎管内外巨大神经鞘膜瘤1例。结果手术时间2.0-4.0 h,出血量200-650 ml。术中未发生椎动脉和脊髓损伤。寰枢椎椎弓根螺钉位置满意。患者全部获5-24个月定期随访,3-6个月后患者均获植骨融合,螺钉位置良好。结论寰枢椎椎弓根螺钉系统内固定融合术治疗上颈椎伤病具有可行性及肯定的三维固定效果。

Objective To investigate the feasibilities,methods,outcomes and indications of atlas pedicle screw system fixation and fusion for the treatment of upper cervical invaliding.MethodsTwelve patients with upper cervical invaliding were treated with atlas pedicle screw system fixation and fusion.Of 12 cases,there were 1 case with congenital odontoid disconnection,2 cases with old odontoid fracture,5 cases with new odontoid fracture,1 case with rupture of the transverse ligament,and 2 cases with C1/2 overhauling operation and 1 case with giant neurilemoma of C1/2.ResultsThe mean operative time was 2.6 h with bleeding amount of 390 ml.No injuries to the vertebral artery and spinal cord were observed.All patients were followed up for 5 to 24 months and achieved a solid bone fusion in 3 to 6 months after surgery.The clinical symptoms were improved and the screws were verified to be in a proper position without breakage or loosening.Conclusion The atlas and axis pedicle screw system fixation and fusion is feasible with better outcomes for the treatment of upper cervical diseases.