三维CT引导下寰枢椎椎弓根螺钉治疗上颈椎不稳

Surgical CT navigation-guided C_(1,2) pedicle screw fixation in treating atlanto-axial instability

目的观察在三维CT引导下后路寰枢椎椎弓根螺钉的置钉准确率及其治疗上颈椎不稳的近期疗效。方法 7例上颈椎不稳患者在三维CT引导下行后路寰枢椎椎弓根钉固定术并行自体髂骨植骨融合,其中先天性齿突不连3例,寰枢不稳3例,陈旧性齿突骨折1例。结果所有病例术后随访3～15个月,临床症状得到不同程度的改善,融合节段获得骨性融合,螺钉位置良好,无松动、断钉,均未发生与置钉相关的并发症。结论寰枢椎椎弓根钉固定治疗上颈椎不稳效果良好,三维CT定位可提高寰枢椎椎弓根螺钉的置钉成功率。

Objective To observe the accurate rate of insertion and the short-term curative effect of surgical CT navigation-guided C1,2 pedicle screw internal fixation in treating atlanto-axial instability.Methods Seven patients with atlanto-axial instability were treated by C1,2 pedicle screw internal fixation and bone graft fusion guided by surgical CT navigation.The patients included 3 with congenital dysplasia of odontoid process,3 with atlanto-axial instability,and one with old odontoid process fracture.Results No vascular or neural injury was found in our group.The patients were followed up for 3-15 months.The clinical symptoms were improved to some extent after operation.No loosening or breakage of screw occurred and bony fusion was achieved in all cases.Conclusion C1,2 pedicle screw fixation is a reliable method for atlanto-axial instability.Surgical CT navigation can help to improve the accurate rate of insertion.