应用C1-2螺钉棒系统行后路复位、固定和融合治疗合并寰-枢椎脱位的颅底凹陷症

目的探讨应用C1-2螺钉棒内固定系统行后路复位、固定和融合治疗寰枢椎脱位的手术疗效。方法 2013年4月至2013年10月,对30例我科收治的合并寰枢椎脱位的颅底凹陷症患者采用寰椎侧块螺钉和枢椎椎弓根峡部螺钉(或下关节突螺钉、颈3椎弓根螺钉)棒内固定系统进行复位、固定并取髂后上嵴松质骨植骨融合。通过术后3D-CT评判复位程度,JOA评分评判临床疗效,并探讨影响手术效果的因素。结果 30例患者中26例达到完全复位,4例为部分复位。其中25例完成了3个月以上随访,CT显示植骨愈合良好,未出现植骨的吸收及内固定的松动。结论 C1-2椎弓根钉棒内固定系统对治疗合并寰枢椎脱位的颅颈交界区畸形可以获得满意的疗效,安全可行。

C1-2 screw-rod system via posterior approach for the treatment of basilar invagination combined with atlantoaxial dislocation

Objective The effect of C1-2 screw-rod system via posterior approach for the treatment of basilar invagination combined with atlantoaxial dislocation is studied. Methods From April to October 2013,30 patients of basilar invagination with atlantoaxial dislocation underwent the posterior operation of reduction and arthrodesis of C1-2 by screws-rod system that planted in the lateral mass of atlas and pars articulars of axis. 3D-CT was used to evaluate the reduction degree and JOA was used to exam the clinical effectiveness.Results Twenty-six of thirty patients obtained complete reduction and 4 achieved partial reduction. A total of25 patients achieved solid fixation during 3 months＇ follow-up and no loss of reduction occurred. Conclusion C1-2 screw-rod system via posterior approach for the treatment of basilar invagination with atlantoaxial dislocation is safe and can achieve the satisfactory outcomes.