枕颈部畸形与创伤的手术治疗

Surgical treatment for occipito-cervical deformity and trauma

目的 探讨枕颈部畸形与创伤的手术疗效。方法 回顾性分析经手术治疗的 7例枕颈部畸形与 6例枕颈部创伤引起脊髓压迫症的临床资料。结果 13例均得以随访 ,时间为 8个月～74个月 ,7例枕颈部畸形予以彻底减压 ,作枕颈融合术 ,现恢复正常工作和生活 5例 ,生活能自理 ,但不能劳动 2例 ;6例枕颈部创伤致齿状突骨折伴寰枢椎脱位 ,能复位 4例 ,其中 3例行寰枢椎融合术 ,1例行齿状突螺钉内固定术 ,不能复位 2例予以寰椎后弓切除枕颈融合术 ,现恢复正常工作和生活 3例 ,生活能自理 ,能参加轻便工作 2例 ,不能参加劳动 1例。结论 手术减压 (或复位 )和重建稳定是手术成功的关键。

Objective To study the effects of surgical treatment of occipito-cervical deformity and trauma.Methods 7 cases deformities and 6 cases traumas of the occipito-cervical region which resulted from compression of the cervical spinal cord were reviewed retrospectively.Results 13 cases were followed-up for 8 months to 74 months.7 cases deformities of the occipito-cervical region were performed completely decompression and occipito-cervical union.5 cases were recoverd.2 cases were no obvious change.6 cases traumas of the occipito-cervical region causing odontoid fracture with atlanto-axis dislocation.3 cases of 4 cases reduction were performed atlantoaxial union.1 case was managed with single-screw anterior fixation of odontoid fracture.2 cases of irreducible atlantoaxial dislocation were treated with resection of the posterior arch of the atlas and bridge grafting of the occipital and axis.3 cases were recoverd.2 cases were significantly improved.1 case had no obvious change.Conclusion The purpose of surgical treatment is to improve the stability and decompression.