AXIS侧块钢板在颈胸段骨折脱位中的应用

Application of cervical lateral mass plate for the fracture and dislocation of the cervicothoracic spine

目的 :观察AXIS钉板侧块内固定系统在颈胸段脊柱骨折、脱位手术中的作用和疗效 ,探讨AXIS的使用技巧及注意事项。方法 :1999年 1月～ 2 0 0 1年 12月 ,对 3例颈胸段脊柱骨折脱位并脊髓损伤患者行后路脱位复位、植骨、AX IS内固定术 ,术后随访观察脊柱复位、植骨融合及脊髓恢复情况。结果 :术后复查X线片证实 3例脱位均完全纠正。术后进行 6～ 13个月 (平均 7个月 )随访 ,术后症状明显恢复、脊髓功能明显改善 2例 ,无变化 1例。术后 6个月 3例均植骨融合 ,融合率达 10 0 %。无钢板和螺钉松动或断裂现象存在。结论 :应用AXIS钉板侧块内固定系统治疗颈胸段脊柱骨折、脱位 ,有以下优点 :入路简单、操作较安全 ,克服了前路不易显露及椎弓根内固定操作困难易损伤脊髓的弊病 ;术中较容易纠正颈 7胸 1脱位 ;可获得术后即刻稳定 ,提高植骨融合率。准确的入钉点、入钉方向及足够的植骨量是确保手术成功的关键。

? Objective To discuss the application of cervical lateral mass plate for the fracture and dislocation of the cervicothoracic spine. Methods From January 1999 to December 2001, internal fixation with cervical lateral mass plate and bony fusion were performed in 3 patients during posterior decompression to treat the fractures and dislocations of the cervicothoracic spine. All patients were followed up from 6 to 13 months (mean, 7 months). Results All patients got complete reduction of antero posterior and rotational dislocation. Neurological deficits were improved in 2 of 3 patients. A stable bony fusion was achieved in all cases in 6 months postoperatively according to radiological criteria. There was no implants breakage and loosening. Conclusion Internal fixation with cervical lateral mass plate and bony fusion for treatment of fracture and dislocation of the cervicothoracic spine can offer simple operation, immediate stability and give a high rate of successful bony fusion for the patients with the fracture and dislocation of the cervicothoracic spine.