寰枢椎椎弓根螺钉内固定治疗Ⅱ型齿突骨折合并寰枢椎脱位

Atlantoaxial pedicle screw internal fixation in treatment of type Ⅱ odontoid fracture combined with atlantoaxial dislocation

目的探讨经后路寰枢椎椎弓根螺钉内固定治疗Ⅱ型齿突骨折合并寰枢椎脱位的临床疗效。方法对2010年10月-2012年9月收治的20例Ⅱ型（Anderson分型）齿突骨折合并寰枢椎脱位的患者行后路寰枢椎椎弓根螺钉内固定术治疗的临床资料进行回顾性分析,所有患者伴有寰枢椎的脱位或半脱位,所有患者无明显脊髓损伤症状,枕颈部疼痛明显,术前常规采用颅骨牵引,平均3.5 d。结果 20例患者术后平均随访16个月,所有患者颈部疼痛缓解明显,骨折固定可靠。结论寰枢椎椎弓根螺钉系统三维固定技术是治疗Ⅱ型齿突骨折并寰枢椎脱位患者一种有效的手术方法。

Objective To evaluate the clinical effect of posterior atlantoaxial pedicle screw internal fixation for the treatment of type Ⅱ odontoid process fracture combined with atlantoaxial dislocation. Methods From 2010 October to 2012 September,the clinical data of 20 cases of type Ⅱ（ Anderson classification） odontoid fracture combined with atlantoaxial dislocation were retrospectively analyzed,all patients underwent the posterior operation of atlantoaxial pedicle screw internal fixation.All the patients were associated with atlantoaxial dislocation or subluxation,and had no symptoms of spinal cord injury,but neck pain significantly. Preoperative conventional skull traction for an average time of 3. 5 d. Results All patients received a mean follow-up of 16 months,all patients with neck pain was relieved,reliable fixation. Conclusion Atlantoaxial pedicle screw system fixation technique is an effective operation method to treat the odontoid type Ⅱ fractures with atlantoaxial dislocation.