后路寰枢椎融合术治疗儿童寰枢椎脱位的远期疗效

Long-term efficacy of posterior atlantoaxial fusion in the treatment of children with atlantoaxial dislocation

目的探讨儿童寰枢椎脱位后路寰枢椎融合术的长期疗效。方法分析2001年6月至2011年6月于郑州大学第一附属医院就诊的26例儿童寰枢椎脱位患者, 收集患者术前及术后影像资料及功能评价结果, 统计分析患者远期疗效。结果患者随访(156.4±47.6)个月, 术后半年时间随访发现患者均实现骨性愈合;C0~C2角术后颈椎弯曲角明显较术前改善(P<0.05);C2~C7角最后一次随访的曲度与手术前比较差异均无统计学意义(P>0.05)。患者的日本骨科协会(JOA)评分, 从术前的平均(9.28±2.37)分提升到末次随访的(14.44±1.28)分, 大部分患者的恢复状态不错, 病情较稳定。JOA评分术后改善率平均值为77.35%, 其中优秀有24例, 良好有5例, 优良率为100%。结论后路寰枢椎融合术是治疗儿童寰枢椎脱位的有效手段, 术后长期疗效良好, 不会对儿童的颈椎曲度和神经功能成显著的不良反应。

Objective To study the long-term efficacy of posterior atlantoaxial fusion in children with atlantoaxial dislocation.Methods A total of 26 children with atlantoaxial dislocation who were treated in the First Affiliated Hospital of Zhengzhou University from June 2001 to June 2011 were analyzed.The preoperative and postoperative imaging data and functional evaluation results were collected,and the long-term efficacy of patients was statistically analyzed.Results The follow-up duration of the patients was(156.4±47.6)months.The patients achieved bone healing during the 6-month follow-up postoperation.The curvature of C2-C7 angle at the last follow-up was not significantly different from that before surgery(P>0.05).The patient’s Japanese orthopedic association(JOA)score increased from the preoperative average(9.28±2.37)to the last follow-up(14.44±1.28).Some patients recovered well and their condition was stable.The average postoperative improvement rate of JOA score was 77.35%,among which 24 cases were excellent,5 cases were good,and the excellent and good rate was 100%.Conclusion Posterior atlantoaxial fusion is an effective method for the treatment of atlantoaxial dislocation in children,with good long-term efficacy after operation,and will not cause significant adverse reactions to children’s cervical curvature and neurological function.