寰枢椎椎弓根螺钉固定治疗齿状突骨折并寰枢关节脱位

目的探讨寰枢椎椎弓根螺钉固定在对治疗齿突骨折合并寰枢关节脱位患者的疗效。方法筛选从2006年11月至2012年9月在我院就诊治疗的21例齿突骨折合并寰枢关节脱位患者,且均是本地居民,在手术前对21例患者进行日本骨科协会(JOA)评分标准进行评分,得分8¹4分,平均分(10.6±1.4)分,在治疗出院后随访时再次进行评分并和术前水平对比。结果对21例患者实施寰枢椎椎弓根螺钉固定术,术后患者均完全复位,且无神经根、脊髓损伤情况,在术后10个月时对患者进行随访调查并复查X线,发现固定情况良好,无松动等情况发生,同时JOA评分1414分,平均分(10.6±1.4)分,在治疗出院后随访时再次进行评分并和术前水平对比。结果对21例患者实施寰枢椎椎弓根螺钉固定术,术后患者均完全复位,且无神经根、脊髓损伤情况,在术后10个月时对患者进行随访调查并复查X线,发现固定情况良好,无松动等情况发生,同时JOA评分14¹7分,平均得分为(15.5±1.2)分。和患者入院时的评分结果对比提升明显(P<0.05),有统计学意义。结论寰枢椎椎弓根螺钉固定术很好的解决了齿突骨折合并寰枢关节脱位患者的困扰,能长期维持颅颈区稳定性,具有一定创新性。

Atlantoaxial Pedicle Screw Fixation,Fusion in the Treatment of Atlantoaxial Instability

Objective To investigate the atlantoaxial pedicle screw fixation in the treatment of patients with atlantoaxial joint dislocation in the treatment ofodontoid fracture. Methods From 2006 November to 2012 September were treated in our hospital 21 cases of patients with odontoid fracture with atlantoaxial joint dislocation, and all local residents, Japanese Association for Department of orthopedics in 21 patients before operation （JOA） score standard score, score 8-14, averaged （10.6± 1.4）%, in the follow-up treatment after discharge again when the score and preoperative level comparison. Results of 21 cases of patients with atlantoaxial pedicle screw fixation, postoperative patients were reduced, and no nerve root, spinal cord injury, for follow-up and X-ray of patients at 10 months after operation, found that fixed in good condition, no loosening occurred, and the JOA score was 14-17, the average score as （ 15.5± 1.2）%. And the admission score results significantly （P〈0.05）, there was statistical significance. Conclusion Aflantoaxial pedicle screw fixation is a good solution to the patients with atlantoaxial joint dislocation problems of odontoid process fracture, can maintain the long-term stability of the craniocervical region, which has certain innovation.