枕颈部畸形减压和植骨融合术远期疗效评价(10年以上随访)

目的探讨枕颈部发育畸形及脊髓压迫症应用枕颈后路手术减压和植骨融合术的远期疗效及评价。方法对114例枕颈部畸形及其不稳实施寰椎后弓和 /或枕骨大孔后缘切除扩大减压 ,并采用自体髂骨作枕骨与第二颈椎棘突基底部间植骨融合固定 ,并进行 10年以上随访。结果　 114例中 ,10 2例获得骨性愈合 ,4例因移植骨骨折致畸形愈合 ,8例移植骨吸收并形成假关节 ;脊髓功能 95例明显恢复 ,14例无明显改善 ,5例手术后病情继续加重。结论枕颈部扩大减压和自体髂骨移植治疗枕颈部畸形及不稳 ,经 10年以上临床观察 ,对枕颈稳定和功能恢复以及头颈运动功能保存有良好作用 ,本项技术是一种有效的治疗方法。

The long-term effect of decompression and bone graft fusion for occipitocervical malformations

ObjectiveTo investigate the long-term effects of decompression and bone grafting for occipitocervical fusion for the treatment of patients with congenital malformations and mylopathy of the occipitocervical spine.Methods The removal of the posterior arcus of atlantis and/or the posterior edge of the foramen magnum for enlarging decompression were performed and then a posterior occiput to C 2 spinous process fusion were performed using the iliac crest bone struts in 114 cases of congenital malformations and instability of the occipitocervical spine. Results All the patients were followed up for more than ten years. 102 cases obtained bone healing, 4 cases obtained abnormal healing for bone graft fracture, 8 cases obtained pseudoarthrosis for bone absorption. The function recovery of spinal cord: 95 cases obtained recovery, 14 cases have no changes, 5 cases worsened after operations. Conclusion The enlarging decompression and autologous iliac crest bone grafting for occipitocervical fusion are proved valuable for the treatment of patients with congenital malformations and myelopathy of the occipitocervical spine. It has been proved effective in the recovery of the occipitocervical stability, the function of spinal cord and the motion of occipitocervical spine.