经口咽入路松解Ⅱ期后路器械融合治疗寰枢椎脱位

目的：评价经口咽入路松解、Ⅱ期后路器械融合治疗陈旧性寰枢椎脱位。方法：经口咽入路寰枢椎前方松解颅骨牵引复位、Ⅱ期后路寰枢椎融合内固定治疗6例陈旧性寰枢椎脱位患者，术后对脊髓功能和颈椎影像学进行评定。结果：术后2年脊髓功能改善2级3例，改善1级2例，无变化1例。术后X线显示寰枢椎复位理想和后方融合满意，MRI显示脊髓压迫解除。结论：经口咽入路行寰枢椎前方松解后颅骨牵引复位、Ⅱ期后路器械融合术治疗陈旧性寰枢椎脱位，临床和影像学评估满意。

Surgical Treatment of Atlanto-axial Dislocation by Transoral Approach Reduction and Posterior Instrumented Fusion

Objective: To evaluate transoral approach reduction and posterior instrumented fusion clinically and radiologically in six patients with atlanto axial dislocation. Methods: The operative methods include two staged steps. The first step is reduction of atlanto axial dislocation through transoral approach followed by skull traction. The second step is staged posterior instrumented fusion of atlanto axial vertebra. Six patients with atlanto axial dislocation underwent this two step operation. The cervical spine image, the spinal cord function and image were observed in all patients after surgery. Results: All patients with atlanto axial dislocation were followed up at least for two years. Remarkable improvement of spinal cord functions were achieved in three patients, improvement in two patients, no change in one patient. The reduction, fixation and fusion of atlanto axial vertebra were also satisfactory in postoperative imaging. Conclusion: Atlanto axial vertebra reduction through transoral approach affords easy performance, and that the ineffective posterior decompression is avoided.