症状性齿状突游离小骨的后路螺钉内固定治疗

Posterior screw internal fixation for the treatment of symptomatic Os odontoideum

目的总结症状性齿状突游离小骨的后路螺钉内固定治疗方法与效果。方法 9例症状性齿状突游离小骨患者采用颈后路寰枢椎螺钉或枕颈螺钉内固定植骨融合术进行治疗,术中采取3D打印模型辅助置钉,比较术前、术后MADI及OA评分评价手术疗效。结果全部病例成功实施了手术,无手术相关并发症发生。7例行术中复位及内固定的患者中,5例完全复位,2例大部分复位,术后MADI显著缩小,所有病例术后JOA评分明显提高,差异均有统计学意义(P=0.000)。结论对伴有寰枢椎脱位的症状性齿状突游离小骨患者,采用术中复位加后路螺钉内固定治疗效果好。

Objective To summarize the method and effect of posterior screw internal fixation for the treatment of symptomatic Os odontoideum .Methods 9 patients with symptomatic OS odontoideum were analyzed retrospectively .All of the patients were underg-one the posterior atlantoaxial or occipital screw internal fixation operations ,and screw placement was assisted by 3D printing models,the curative effect was evaluated by comparison the preoperative and postoperative MADI and JOA score .Results All of the patients were successfully treated without operation related complications ,in 7 cases underwent reduction and posterior screw internal fixation ,5 cases were completely reducted ,2 cases were reducted .Compared with the preoperative ,the postoperative MADI was significantly reduced ,the postoperative JOA score 3 months after operation was significantly increased ,the difference was statistically significant （P=0.000）. Conclusion The effect of reduction and posterior screw internal fixation for the treatment of the patients with symptomatic Os odontoi -deum complicated by atlantoaxial dislocation is excellent .