后路椎弓根螺钉内固定治疗寰枢椎骨折脱位的临床体会

Posterior pedicle screw fixation for treatment of fracture and dislocation of atlantoaxial spine

目的探讨经后路椎弓根螺钉内固定治疗寰枢椎骨折脱位临床疗效。方法选取2011年6月至2013年12月在该院接受治疗的寰枢椎骨折脱位患者19例,经后路切开复位椎弓根螺钉内固定术。术后定期复查X线片了解骨折脱位矫正和后路植骨融合。参照日本骨科学会(JOA)评分评估神经功能。结果患者植骨全部融合,内固定无松动,无断钉、断棒发生,JOA评分由术前(7.35±2.39)分改善至术后(13.21±2.53)分,差异有统计学意义(P<0.05)。结论后路寰枢椎椎弓根螺钉内固定治疗上颈椎损伤疗效满意。

Objective To investigate the clinical effect of pedicle screw fixation in the treatment of fracture and dislocation of atlantoaxial spine via posterior approach.Methods 19 patients with fracture and dislocation of atlantoaxial spine in this hospital from June 2011 to December 2013 were selected and treated with open reduction and pedicle screw fixation via posterior approach.The X-radiographs were postoperatively re-examined at regular time for understanding the correction of fracture and dislocation and implant fusion results,the neurological functions were evaluated according to the Japanese Orthopaedic Association（JOA）scores.Results All cases got bony fusion without the occurrence of internal fixation loosening,broken screw or broken rod.The JOA score was improved from preoperative（7.35±2.39）points to postoperative（13.21±2.53）points（P〈0.05）.Conclusion The posterior atlantoaxial pedicle screw fixation and fusion for treating upper cervical spine injury has satisfactory effect.