多普勒超声观察创伤性寰枢椎不稳手术前后椎动脉血流的变化

Evaluation of vertebral artery blood flow before and after internal fixation surgery in patients with traumatic atlantoaxial instability by color Doppler ultrasound

目的探讨创伤性寰枢椎不稳患者内固定手术前后椎动脉血流的变化。方法 32例创伤性寰枢椎不稳患者,其中男性22例,女性10例;年龄22～57岁,平均年龄38岁。手术前及内固定术后,均应用彩色多普勒超声测量颈椎1、2间和颈椎5、6间椎动脉血流速度、阻力指数,并对检查结果进行对比分析。结果 32例创伤性寰枢椎不稳患者术前椎动脉血流39侧异常,25侧正常。内固定术后39侧异常者中35侧恢复正常,4侧无变化,3侧术前正常变为术后异常。结论创伤性寰枢椎不稳可导致椎动脉血流变化,手术复位内固定后增加了寰枢椎稳定性,可改善椎动脉血液供应。

Objective To discuss the changes in vertebral artery blood flow before and after internal fixation surgery on patients with traumatic atlantoaxial instability. Methods A total of 32 vertebral arteries patients with traumatic atlantoaxial instability were enrolled, male 22, female 10, aged 22 - 57 years old, mean age 38 years old. Before and after internal fixation surgery, all of them were performed color Doppler ultrasound to measure vertebral artery blood flow velocity and resistance index in carotid 1 - 2 and 5 - 6. Results In the 32 patients with traumatic atlantoaxial instability before surgery, 39 sides of vertebral artery blood flow were abnormal, 25 sides were normal. After internal fixation surgery, 35 of the 39 abnormal sides returned to normal with 4 sides demonstrated no change, 3 normal sides before surgery became abnormal after surgery. Conclusion It is demonstrated that traumatic atlantoaxial instability could lead to change in vertebral artery blood flow, and increase the stability of atlantoaxial joint could improve vertebral artery blood supply.