肌性斜颈合并寰枢椎关节半脱位

Congenital muscular torticollis with subluxation of atlantoaxial joint

目的:确定肌性斜颈患者有无寰枢椎异常改变并探讨其对手术效果的影响。方法:2 1例肌性斜颈患者术前行颈 1～ 3CT检查 ,自行设计测量方法测得枢椎齿状突侧向偏移值。结果 :2 1例中 11例有不同程度寰枢椎关节旋转性半脱位 ,表现为枢椎齿状突轴线与寰椎轴线分离 ,枢椎齿状突侧向移位 ,严重者偏移侧枢椎齿状突与寰椎侧块间距离几乎消失。 结论 :寰枢椎关节旋转性半脱位可认为是肌性斜颈的又一继发畸形 ,它的确定有助于解释在成功的斜颈矫正术后部分患者仍有习惯性头颈部偏斜的现象。肌性斜颈患者术前应常规行颈 1～

Objective: To determine if there is the subluxation of atlantoaxial joint in the patients with congenital muscular torticollis and its effect on the result of the operation. Methods: 1～3 cervical spine CT scan was done in twenty one patients with clinically certain congenital muscular torticollis before operation. The separation values of axial lines of atlas and axia were surveyed with the method designed by the author. Results: Eleven of the twenty one patients had rotatory subluxation of the atlantoaxial joint to a greater or lesser degree,showing the separation of the axial lines of atlas and axis; the side displacement of the odontoid process of axis and the nearly disappearing of the distance between the odontoid process of axis and side block of atlas in serious cases. Conclusion: Rotatory subluxation of the atlantoaxial joint can be considered to be another secondary deformity of the congenital muscular torticollis and its recognition in patients with congenital muscular torticollis may help to explain residual head neck posturing problems even after successful operative treatment. 1～3 cervical spine CT scan should be done in every patients with congenital muscular torticollis.