后路椎弓根螺钉治疗齿状突骨折合并寰枢椎不稳

Posterior Pedicle Screws for Treatment of Odontoid Fracture Complicated by Atlantoaxial instability

目的探讨经颈椎后路椎弓根螺钉治疗齿状突骨折合并寰枢椎不稳的临床疗效及手术可行性分析。方法回顾性分析2009年8月至2013年2月我院采用后路椎弓根螺钉治疗齿状突骨折合并寰枢椎不稳28例患者资料,Ⅱ型齿状突骨折伴寰枢椎不稳定19例,Ⅲ型齿状突骨折伴寰枢椎脱位9例,随访患者临床症状缓解程度、复位及植骨融合情况。结果所有螺钉位置良好,骨折与复位及固定满意。28例患者均获得随访,平均随访18个月,X线片、CT显示寰枢椎达到骨性融合,内固定物未松动及断裂。临床症状改善优良率89.3%。结论后路椎弓根螺钉治疗齿状突骨折合并寰枢椎不稳具有生物力学稳定性好,复位满意,固定可靠,植骨融合率高,最大限度地保留颈椎活动度,临床症状改善满意。

Objective To investigate by posterior cervical pedicle screw for the treatment of odontoid fracture combined atlantoaxial instability of clinical efficacy and surgical feasibility analysis. Methods Retrospective case analysis, from august 2009 to February 2013, with posterior pedicle screw for treatment of odontoid fracture with atlantoaxial instability in 28 patients, II type dentate process fracture with atlantoaxial instability in 19 cases type III odontoid process fractures with atlantoaxial dislocation nine cases patients were followed up for clinical symptoms of the degree of reduction and interbody fusion. Results All good screw position, fracture reduction and fixation of satisfaction. 28 patients were followed up for a mean follow-up of 18 months,X-ray, CT display atlantoaxial achieve bone fusion and internal fixation is not loose and broken. Clinical symptoms improved excellent rate of 89. 3%. Conclusion Posterior pedicle screws in the treatment of odontoid fracture with atlantoaxial instability biomechanical stability is good, satisfactory reduction, reliable fixation, interbody fusion rate, maximize the retention of cervical activity, clinical symptoms improved satisfaction .