寰枢关节脱位的影像学表现及分型探讨

目的探讨"寰枢关节脱位/半脱位"的影像学特征及分型。方法收集经临床证实的"寰枢关节脱位/半脱位"病人46例,以CT为主要检查手段,结合文献资料,分析其影像学表现特征并进行分型探讨。结果 46例病人根据寰枢关节寰齿前间隙、寰齿侧块间隙、寰枢椎相对旋转角度及寰枢椎的相对位置关系分为寰枢关节前脱位/半脱位4例、侧方脱位/半脱位24例、旋转脱位/半脱位10例,复合脱位8例;文献报道的后脱位1例。结论 "寰枢关节脱位/半脱位"的影像学分型可在一定程度上反映其发病机制并为治疗措施的选择提供参考,前脱位/半脱位、侧方脱位/半脱位、旋转脱位/半脱位采用保守方法治疗多数可取得满意疗效,后脱位、复合脱位一般需要手术治疗。

Imaging Classification Investigation of Atlanto-Axial Joint Dislocation

Objective To investigate imaging classification of atlanto-axial joint dislocation/subdislocation. Methods 46 patients with atlanto-axial joint dislocation/subdislocation were investigated and classified through CT mainly and literatures. Results According to Anterior Atlanto-Dental Interval （AADI）. Lateral Atlanto-Dental Interval（LADI）, Variance of Bilateral Atlanto-Dental Interval （VBLADI）, Rotating Angle of Atlas on Denta（RAAD）,46 cases are classified into 5 groups：4 cases with Atlanto-Axial Anterior Dislocation （AAAD）. 24 cases with Atlanto-Axial Lateral Subdislocation （AALSD）, 10 cases with Atlanto-Axial Rotated Dislocation （AARD）, 8 cases with Atlanto-Axial Compound Dislocation （AACD）, 1 case with Atlanto-Axial Posterior Dislocation （AAPD） from literature. Conclusions The imaging classification of atlanto-axial joint dislocation/subdislocation reveals the mechanism and causes of this entity. Conservative care is preferential option for ADAA, LDAA or RDAA, however, operation is necessary for PDAA and CDAA frequently.