颈前路加压螺钉内固定治疗齿状突骨折的临床研究

Clinical Analysis on Cervical Anterior Compression Screw for Odontoid Fracture

目的探讨颈前路加压螺钉内固定治疗Ⅱ型和浅Ⅲ型新鲜齿状突骨折的疗效及安全性。方法对揭阳市人民医院2009年1月-2011年1月经颈前路加压螺钉内固定治疗齿状突骨折23例临床资料进行回顾分析,其中Ⅱ型16例,浅Ⅲ型7例。所有患者术前均行颅骨牵引复位,均采用单枚螺钉固定。术前、术后及末次随访均行颈椎正侧位及张口位X片和颈椎CT、MRI检查以观察骨折复位情况。结果所有患者均获随访,术后随访时间6～14个月,平均11个月,骨折复位满意,所有骨折全部骨性愈合。术中、术后无严重并发症,固定螺钉无松动、移位或断裂。23例患者枕颈部基本恢复正常的颈椎活动度,尤其是颈部旋转、屈伸功能。结论经颈前路加压螺钉内固定治疗成人Ⅱ型和浅Ⅲ型新鲜齿状突骨折,骨折愈合率高,并发症少,术中出血少,术后恢复快,能较好地保留颈椎正常活动度,尤其是颈部旋转、屈伸功能,是治疗该类型骨折较好的选择,值得推广。

Objective To investigate effect and security on internal fixation of cervical anterior compression screw for the frest type Ⅱ and superficial Ⅲ odontoid fracture.Methods Review and analyze 23 patients with odontoid fracture were treated with internal fixation of cervical anterior compression screw from January 2009 to January 2011 in our hospital,including 16 patients of type Ⅱ and 7 type superficial Ⅲ.Skull traction was performed in all patients preoperatively and underwent percutaneous anterior odontoid screw fixation with one screw implant.All patients had adem position and mouth-open X-ray film,CT and MRI check about cervical vertebra when having follow-up before,after operation and final time.All check results were used to observe Odontoid Fracture resetting changes.Results All patients were followed up 6-14 months after operation,the mean time was 11 months,which showed bone healing in all of them.During and after operation,no serious complication was found,nor loosening,dislocation or breakage of internal fixation screws.Conclusion Internal fixation of cervical anterior compression screw for the frest type Ⅱ and superficial Ⅲ odontoid fracture,this kind of therapy method can increase healing,reduce complication and bleeding during operation,promote recover after operation,can keep normal activity degree of cervical vertebra well,particularly gyrate,bent and straight function.So it was worth extending and applying for the frest type Ⅱ and superficial Ⅲ odontoid fracture.