几种经后路手术治疗创伤性寰枢椎不稳的方法比较

目的：对经后路手术治疗创伤性寰枢椎不稳的几处方法进行回顾总结，评价APOFIX椎板钩内固定并后路．融合术的效果。方法：对25例创伤性寰枢椎不稳患者行后路手术，包括齿突骨折20例，横韧带断裂5例，其中Gallie钢丝并后路融合术12例，Brooks钢丝并后路融合术9例，APOFIX椎板钩并后路融合术4例，结果：术后随访6－40个月（平均21个月），全部行颈椎侧位X线片检查，部分行MRI,有性融合分别为Gallie法10例（83％），Brooks法8例（89％），APOFIX法4例（100％），结论：APOFIX椎板钩并后路融合术操作简便，稳定，效果好，并发症少且不影响MRI成像而有利随访，是治疗创伤性寰枢椎不委较为理想的一种方法。

Comparison among several posterior operations for the treatment of traumatic atlantoaxial instability

Objective:To review and summarize the experiences in posterior operations for the treatment of traumatic atlantoaxial instability and evaluate the effect of posterior atantoaxial fusion using APOFIX interlaminar clamp.Methods:Twenty five patients with traumatic atlantoaxial instability(including 20 patients with unstable odontoid fractures,5 patients with disrupted transverse ligament) were operated on posteriorly.Autogenous iliac bone transplantations were performed in all cases,Gallies wire fixations were performed in 12 patients,Brooks wire fixations were used in 9 patients and APOFIX interlaminar clamps were utilized in 4 patients.Results:Follow up period ranged from 6 to 40 months(average 21 months).All patients were followed up with lateral cervical radiographs and some of them were followed up with MRI.Osseous fusion was achieved in 10 of 12 patients (83%),8 of 9 patients(89%),and 4 of 4 patients(100%)respectiveily.Conclusion:Based on its ease of use,rigid stabilization,good results,lack of complications and compatibility with MRI,the APOFIX interlaminar clamp with bone grafting provided an ideal method for traumatic atlantoaxial instability.