寰椎椎弓根钉与侧块钉治疗寰枢椎骨折临床疗效的比较

目的 分析寰椎椎弓根钉与寰椎侧块钉治疗寰枢椎骨折的临床疗效.方法 2007年8月～2011年11月,我院对46例寰枢椎骨折的患者进行手术治疗,其中25例采用寰椎侧块钉技术,21例采用寰椎椎弓根钉技术.通过比较术中出血量、手术时间、日本骨科协会评分（JOA）以及骨折愈合情况,对两组内固定技术的临床疗效进行分析.结果 所有患者均获得随访,随访时间24～60个月,平均32个月,术后6个月骨折均获得骨性愈合,未出现内固定失败,疼痛均明显缓解,两组JOA评分比较差异无统计学意义.与寰椎侧块钉组相比,寰椎椎弓根钉组手术时间明显缩短,术中失血量明显减少.结论 寰椎椎弓根钉固定损伤较小,操作相对简单,可优先采用.

Comparison of Effects of C1 Pedicle Screw and C1 Lateral Mass Screw Fixation in Treatment of Atlantoaxial Fracture

Objective To compare the efficacy of posterior C1 pedicle screw fixation and C1 lateral mass screw for atlantoaxial fracture. Methods From August 2007 to November 2011, 46 patients with atlantoaxial fracture were treated with posterior C1 pedicle screw fixation or C1 lateral mass screw fixation. Among them, there were 25 patients underwent C1 lateral mass screw fixation and 21 patients received C1 pedicle screw fixation. The blood loss, the operating time, the JOA score and bony fusion were recorded in every patient and compared between the two groups. Results All patients were followed up for an average of 32 months,ranged from 24 months to 60 months. The blood loss was obviously less and the operating time was obviously shorter in the posterior C1 pedicle screw fixation group. During the follow up period, all pediele screws and lateral screws were in good position, cervical alignment was also maintained. All patients achieved bony fusion 6 months after operation. Conclusion Posterior C1 pedicle screw fixation is less invasive and easier to manipulate compared with posterior C1 lateral mass screw fixation in atlantoaxial fracture.