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使用枢椎椎弓根螺钉和枕颈固定板的枕颈融合术
作者姓名:Wang C  Yin SM  Yan M  Zhou HT  Dang GT
作者单位:1. 100083,北京大学第三医院骨科
2. 承德医学院附属医院骨科
摘    要:目的观察一种借助于枢椎椎弓根螺钉的枕颈固定装置治疗寰枢关节不稳定的效果。方法从2001年6月至2003年3月用自行设计的一套由椎弓根螺钉和枕颈固定板组成的枕颈固定器,治疗了38例寰枢关节不稳定的患者,其中24例有寰椎枕骨化。沿枢椎椎弓峡部的纵轴安置椎弓根螺钉,将枕颈固定板预弯后固定于枕骨,用螺母锁定固定板与椎弓根钉的过程中,利用固定板的曲度,使寰枢关节充分复位。植骨于枕骨与枢椎后弓间。结果36例获得了随访,平均18个月,均获得了骨性融合。没有神经、血管损伤和断钉、断板的病例。结论使用枢椎椎弓根螺钉和枕颈固定板的枕颈固定器不仅有可靠的、短节段固定作用,而且便于寰枢关节复位。

关 键 词:枢椎椎弓根螺钉  枕颈固定板  枕颈融合术  寰枢关节不稳定

Posterior occipitocervical fixation using C2 pedicle screws and occipitocervical plate systems
Wang C,Yin SM,Yan M,Zhou HT,Dang GT.Posterior occipitocervical fixation using C2 pedicle screws and occipitocervical plate systems[J].Chinese Journal of Surgery,2004,42(12):707-711.
Authors:Wang Chao  Yin Shao-Meng  Yan Ming  Zhou Hai-Tao  Dang Geng-Ting
Institution:Department of Orthopaedics, Peking University Third Hospital, Beijing 100083, China.
Abstract:Objective To observe the clinical effect of a occipitocervical fixation systems using C 2 pedicle screws and plates Methods An occipitocervical fixation system was designed Since June 2001 to March 2003,38 patients with instability of atlantoaxial joint underwent reconsctructive surgery using this systems Twenty four patients were associated with congenital occipitalization The pedicle screws were inserted into C 2 pedicles in the direction as its axis The occipitocervicle plate was slightly bent to fit the occipital contour and fixed onto the occiput Hyperflexion alignment of the occipitoatlantoaxial complex was corrected by application of extensional force created by tightening of the nut on the pedicle screws The autogenous cancellous bones were grafted between the occiput and the axis Results In this series,neither vertebral artery nor spinal cord was injuried 36 of 38 cases were followed up for an average of 18 months,all cases achieved solid bony fusion No implant failure was found Conclusions Occipitocervical reconstruction by the combination of C 2 pedicle screws and occipitocervical plate systems can provide sufficient correction of malalignment in the occipitoatlantoaxial region and achieve high fusion rate
Keywords:Spinal fusion  Atlantoaxial joint  Joint instability
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