基于骨外科仿生治疗理念探讨寰枢椎脱位的临床分型及治疗策略

Clinical classification and treatment of atlantoaxial dislocation based on the bionic orthopaedic surgery

寰枢椎脱位是一种具有临床挑战性的脊柱外科疾病,可引起患者四肢麻木无力、大小便功能障碍,严重者可致循环紊乱和呼吸功能障碍。传统治疗主要是松解复位,解除压迫,局部坚强固定融合,术后常伴有颈椎活动受限。与传统治疗理念不同,骨外科仿生治疗理念主张尽可能保留脊柱活动功能,遵循结构稳定、功能最优的仿生学治疗理念,在实现寰枢椎脱位解剖复位的同时,最大限度保留上颈椎运动功能。本文旨在从仿生骨外科学的角度出发,对寰枢椎脱位的临床分型、治疗的选择和内固定技术的演变进行简明阐述,以期为寰枢椎脱位治疗策略的选择提供新的思路和见解。

Atlantoaxial dislocation(AAD)is a clinically challenging spinal surgery disease that can cause numbness and weakness of limbs,dysfunction of urination and defecation,even circulatory disorder and respiratory dysfunction in severe cases.The traditional treatment mainly involves loosening and reduction,relieving compression,local rigid fixation,and fusion,and is often accompanied by limited cervical activity after surgery.The bionic treatment concept of orthopaedic surgery differs from the traditional treatment concept.It advocates retaining the spinal movement function as much as possible,following the bionic treatment concept of stable structure and optimal function,and maximizing the upper cervical movement function while achieving AAD anatomical reduction.From the perspective of bionic orthopaedic surgery(BOS),this article aims to briefly describe the clinical classification of AAD,the choice of treatment and the evolution of internal fixation technology to provide a new idea and insight for the choice of treatment strategies for AAD.