摘要
【目的】分析探讨上位颈椎疾患的治疗效果。【方法】2000年11月至2002年6月,共手术治疗上位颈椎疾患20例,陈旧性齿突骨折11例,新鲜齿突骨折5例,Hangman骨折2例,颈1/2脱位伴颅底凹陷4例,其中齿突发育畸形1例,先天性寰椎后弓缺如伴Klippel-Feil综合征1例,先天性寰枕融合伴Klippel-Feil综合征2例。日本矫形外科协会(JapaneseOrthopaedicAssociation,JOA)颈髓症评分5.0~17.0,平均13.2。【结果】手术用时80~180分,平均138.9分。术中出血量30~200mL,平均115mL。随访时间3~24个月,平均12.06个月。术后JOA评分10.5~17.0,平均16.3。再次手术1例。【结论】手术要尽可能在复位状态下进行,后路寰枢内固定应复位90%以上,而前路齿突螺钉内固定则必须完全复位,正确的术后护理是保持治疗效果的保证。
To analyze the surgical outcome of internal fixation for upper cervical spinal diseases. From November 2000 to June 2002, 20 cases suffered from upper cervical spinal diseases, including 11 old odontoid fractures, 5 acute odontoid fractures, 4 C1/2 dislocations with basilar impession, were studied. Of whom, there was one case of developmental odontoid abnormity, and one case of congenital atlantal posterior tubercle absence with Klippel Feil syndrome, and two cases of congenital atlanto occipital fusion with Klippel Feil syndrome.All were treated surgically. The Japanese Orthopaedic Association(JOA) scores of all subjects were 5.0 to 17.0, averaging 13.2. The times of operation were 80 to 180 min, averaging 138.9 min. The loss of blood in operation was 30 to 200 mL, averaging 115 mL. The follow up periods were 3 to 24 months, averaging 12.06 months.The JOA scores were 10.5 to 17.0 postoperatively, averaging 16.3. One case was re operated.[Conclusion]Before operation, the reduction of deformities should be reduced as much as possible. For posterior atlatoaxial fusion, the reduction should reach at least 90 percent. As for odontoid fracture, the anatomical complete reduction was required in anterior dens screw fixation. The correct postoperative care was also the key of success.
出处
《中山大学学报(医学科学版)》
CAS
CSCD
北大核心
2003年第6期597-599,共3页
Journal of Sun Yat-Sen University:Medical Sciences
关键词
治疗
齿突尖
枢椎
脊柱骨折
脱位
骨折固定
odontoid process
axis
spinal fractures
dislocations
fracture fixation, internal