Iso-c 3D计算机导航下颈前路齿突螺钉治疗Ⅱ型齿状突骨折

Management of type II odontoid fracture with anterior screw fixation using Iso-c 3D guidance

目的:探讨导航技术在颈前路螺钉内固定手术治疗齿状突骨折的准确性、疗效以及并发症情况。方法:对2010-01-2012-12我院骨科于导航下手术治疗的Ⅱ型齿状突骨折17例患者进行随访,其中男10例,女7例,年龄13~61岁,平均36.2岁,随访时间8~37个月,平均随访13.8个月。全部患者应用Iso-c 3D导航系统置入齿状突螺钉,于术后1周、3、6、12个月行X光检查,观察骨折愈合情况和上颈椎稳定性。结果:全部患者均顺利完成手术,无并发症发生。手术时间82~196min,平均118min;出血量80~210ml,平均116ml;术中透视时间(不包括注册时间)105~210s,平均125s。全部患者的切口均一期愈合,螺钉固定牢固可靠,骨折愈合良好,全部患者无上颈椎不稳定发生。结论:应用Iso-c 3D导航系统植入螺钉治疗Ⅱ型齿状突骨折安全、可靠。

Objective：To assess the accuracy,clinical outcome and complications for treating odontoid fracture with an anterior odontoid screw through isocentric C-arm three-dimensional（Iso-c 3D）guidance.Method：All 17 patients with type II odontoid fractures treated with anterior odontoid screw through Iso-c 3D guidance from Jan2010 to Dec 2012 were followed up,10 males and 7 females,age from 13 to 61,with an average of 36.2 years,the median duration of follow-up was 13.8 months,（range 6~37 months）.The X ray examination was taken 1 week,3 months,6months,12 months,after the toperation to evaluate the healing and stabilization of upper cervical.Result：All patients had surgical treatments successfully without complications.The operation time is 82~196 min,average operation time is 118 min;blood loss is 80~210 ml,average blood loss is 116 ml;intraoperative radiation time is 105 s^210 s,average intraoperative radiation time is 125 s.Operative incision of all patients had a primary healing,a strong inner fixation and good fusion without upper cervical destabilizing.Conclusion：The technique of anterior screw odontoid fixation with Iso-c 3D guidance is an efficacious and safe method in treating with type II odontoid fractures.