导航辅助下后路短节段固定治疗寰枢椎骨折的疗效

Effects of Posterior Short Segment Fixation Treatment of Atlantoaxial Fracture Under Navigation System

目的探讨导航辅助下后路短节段椎弓根螺钉固定寰枢椎骨折的治疗效果、安全性、准确性。方法回顾性分析2015-01/2018-03月作者医院收治的23例寰枢椎骨折患者的临床资料,观察临床疗效及置钉的准确性。结果本组23例中,共置入102枚椎弓根螺钉。术中2例患者发生硬脊膜破裂、1例肿瘤患者出现椎动脉破裂。术后CT显示102枚椎弓根螺钉中有3枚螺钉穿破椎弓根,穿透皮质率2.94%,神经未见明显侵扰。术后复查显示:骨折脱位复位均满意,颈椎生理曲度恢复良好,经随访所有病例无断钉及内置物松动现象。结论导航辅助下后路短节段椎弓根螺钉固定寰枢椎骨折具有良好的准确性、安全性和临床效果。

Objective To explore the clinical efficacy,safety and accuracy of posterior short segment pedicle screw fixation treatment of atlantoaxial fracture under navigation assistance.Methods A total of 23 patients with atlantoaxial fracture in author’s hospital from January 2015 to October 2018 were retrospectively analyzed.All patients were underwent short-segment pedicle screw fixation under the guidance of navigation system,the clinical effect and accuracy of screw were observed.Results A total of 102 pedicle screws were inserted in 23 patients.Dural rupture occurred in two patients and vertebral artery rupture occurred in one tumor patient.Postoperative CT results showed that 3 pedicle screws were incorrect position,the rate of penetrating cortex was 2.94%,no nerve damage.Postoperative review showed that the restoration of fracture and dislocation were satisfactory,and the physiological curvature of cervical vertebra recovered well.No broken nails or loose implants were found in all cases after follow-up.Conclusion Navigation system with short-segment pedicle screw fixation of atlantoaxial fracture fixation has excellent accuracy,safety and clinical effect.