枕颈CD在枕颈融合术中的应用

The application of CD-cervical system in posterior occipitocervical fusion

目的 探讨枕颈CD在枕颈融合术中的方法和疗效。方法 对 2 5例不同原因引起上颈段失稳病例 (新鲜骨折 7例、陈旧性寰枢椎脱位 18例 ) ,采用枕颈CD为内固定器械进行枕颈融合术 ;随访手术效果。结果 所有病例得到随访 ,随访期大于 1年。 2 5例均获得骨性融合。新鲜外伤所致 3例神经损伤者 ,1例术前双手指麻木术后症状消失 ,术前不完全脊髓损伤者 ,1例术后神经功能由ASIAC级改善为D级 ,1例D级无改变。 18例脊髓慢性压迫损伤病例神经功能改善率 71%。 1例前路减压时出现咽升动脉损伤并遗留脑缺血后遗症。所有病例未出现与内固定有关的神经脊髓损伤、椎动脉损伤和脑脊液漏等并发症。结论 枕颈CD固定可靠 ,操作简单、安全 ,并发症少 。

Objective To evaluate the application of CD-cervical system internal fixator in posterior occipitocervical fusion. Methods 25 cases of upper cervical instability caused by trauma or congenital reasons were treated with occipitocervical fusion using CD-cervical system (Sofamor-Danek, USA). All cases patients were followed for the outcome of internal fixation and fusion. Results All patients were followed for at least 1 year. All had perfect bone fusion. In 3 patients with neurological defect because of acute trauma, one patient with preoperation numbness of fingers showed on symptom after operation; one improved from ASIA C to D while another patient of D scale had no change. The neurological function patients suffered from chronic atlanto axis subluxation recovered at ratio of 71% according to the criterion established by ourselves. There were no complications related to the internal fixation operation. Conclusion The CD-cervical system stable, safe, simple and with less complications. It provides sufficient internal fixation in occipitocervical fusion